Written questions by Brown-Fuller.

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.

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.

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.

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

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.

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 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 (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.

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.

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

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.

Whether targets to improve early diagnosis of myeloma will form part of the national cancer plan.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers such as myeloma, as well as other unstageable cancers, as early and quickly as possible, and to treat it faster, in order to improve outcomes.To tackle late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.We will get the NHS diagnosing blood cancer earlier and treating it faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.

What comparative assessment he has made of the adequacy of the availability of ultrasound in primary care in (a) the UK, (b) Germany and (c) the Nordic nations; and what steps his Department is taking to expand access to diagnostic ultrasound in UK primary care (i) for gynaecological conditions and (ii) in general.

We are committed to transforming diagnostic services and will support the NHS to increase diagnostic capacity to meet the demand for diagnostic services.Our 10-Year Health Plan commits to shifting care from hospital to community, including diagnostic tests, and to ensuring care is more integrated across primary and secondary care.Diagnostic tests, such as ultrasounds, should be more easily accessible and located in the community and directly referred from primary care where possible, which is more convenient for patients than going to hospital. We have committed to build upon the current 169 Community Diagnostic Centres (CDCs) that are open across the country by expanding a number of these and by building up to five new CDCs, as well as expanding the number of CDCs that are open 12 hours a day, 7 days a week.We are also working to improve access for GP services to diagnostic tests, for example in CDCs. The GP Direct Access Programme has published guidance on the use of urgent direct access referrals to specific diagnostic tests. This includes, for example, ultrasounds for abdomen and pelvis for suspected different intra-abdominal cancers including those of the pancreas, colon, urological tract or lymphoma. Guidance is available at the following link: https://www.england.nhs.uk/long-read/urgent-gp-direct-access-to-diagnostic-services-for-people-with-symptoms-not-meeting-the-threshold-for-an-urgent-suspected-cancer-referral/.The Department of Health and Social Care has not currently made a comparative assessment of the adequacy of the availability of ultrasound in primary care in, the UK, Germany and the Nordic nations. NHS England monitors the age and distribution of imaging assets including ultrasound scanners (for non-obstetric use) across the country via its annual National Imaging Data Collection, which is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/national-imaging-data-collection/.In March 2024, there were 3,468 ultrasound scanners assets in England, an increase of 467 compared to 3,001 in March 2023.

What steps his Department is taking to reduce the number of people on NHS waiting lists in Chichester constituency.

The Government is committed to putting patients first. Tackling waiting lists is a key part of our Health Mission. We have now exceeded our pledge to deliver an extra two million operations, scans, and appointments, having now delivered 4.9 million more appointments. 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. Our Reforming elective care for patients plan, published in January, sets out how the NHS will reform elective care services and deliver on our ambitions.We are transforming diagnostics to cut long waits through community diagnostic centres (CDCs). Patients in the Chichester constituency are likely to be referred to either Bognor Regis War Memorial Hospital CDC, which has been delivering diagnostic activity since November 2021, or the University of Chichester Bognor Regis CDC, which has been delivering diagnostic activity since March.Dedicated and protected surgical hubs are transforming the way that NHS provides elective care by focusing on high-volume low-complexity surgeries. As of September, there are currently 120 operational surgical hubs across England. In Sussex, there is currently one operational surgical hub, at the Sussex Orthopaedic Treatment Centre, which opened in 2012. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals. The Department is committed to ramping up the number of hubs over the next three years so that more operations can be carried out.

What steps he is taking to increase the number of full-time psychiatrists in the NHS (a) nationally and (b) in Chichester constituency.

Decisions about recruitment are matters for individual National Health Service trusts. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.However, we know that the NHS has been facing workforce shortages for a number of years. While there has been growth in the mental health workforce over recent years, more is needed. That is why, as part of our mission to build an NHS that is fit for the future and that is there when people need it, the Government is recruiting an additional 8,500 mental health workers, including psychiatrists, by the end of this Parliament. We are more than halfway towards this target, which will help to ease pressure on busy mental health services.

Whether he plans to (a) implement the Care Act 2014 provisions on protecting individuals from unaffordable care costs and (b) introduce a more generous means test for social care funding.

In July 2024, the Chancellor of the Exchequer announced that the planned adult social care charging reforms, which were inherited from the previous government, would not be taken forward in October 2025.The means test thresholds for support with adult social care costs are reviewed annually. The rates for the next financial year will be published via a Local Authority Circular in due course.The Government is committed to reforming the adult social care sector. We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The Terms of Reference are sufficiently broad to enable Baroness Casey to independently consider how to build a social care system fit for the future, including considering the affordability of care costs if she sees fit.

What steps he is taking to widen access to appropriate therapy treatments for people with post-traumatic stress disorder (a) nationally and (b) in Chichester constituency.

The NHS Sussex Integrated Care Board is responsible for commissioning services to meet the mental health needs of the people in Chichester.People with post-traumatic stress disorder can self-refer to NHS Talking Therapies or their general practitioner can refer them.Nationally, the Government is investing an extra £688 million this year to transform mental health services. We have chosen to prioritise funding to expand NHS Talking Therapies, so that the number of people completing a course of treatment is expected to increase by 384,000 by 2028/29.We are also delivering on our commitment to recruit an additional 8,500 mental health workers for children and adults by the end of this Parliament. We are more than halfway towards this target, which will help to ease pressure on busy mental health services.

What plans his Department has to improve the (a) protection, (b) promotion and (c) support of optimal infant feeding.

It is important that all families are supported to make the right choices for them and to achieve their infant feeding goals. This includes families who cannot breastfeed or choose not to. We know that breastfeeding has significant benefits and are committed to encouraging and supporting breastfeeding.Most families will receive infant feeding information and support from midwives and health visitors. We are taking action to strengthen these services. We are taking further steps, including investing £18.5 million through the Family Hubs and Start for Life programme in 2025/26 to encourage breastfeeding and to provide infant feeding support across 75 local authorities in England. We have increased the capacity of the National Breastfeeding Helpline. The Start for Life communication programme also includes advice on breast and bottle-feeding and introducing solid foods.

Whether his Department has made an assessment of the potential merits of widening the scope of the infant formula legislation to include the (a) digital and (b) other marketing of all (i) formula milks up to age 36 months and (ii) (A) bottles, (B) teats and (C) other equipment.

Infant feeding is critical to a baby’s healthy growth and development. The Government is committed to giving every child the best start in life, and that includes helping families to access support to feed their baby.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 and follow on formula are safe and meet the nutritional requirements of babies and infants.The regulations cover the composition, marketing, and labelling of infant formula and follow-on formula but they do not cover bottle, teats, or other equipment, and there are no plans to extend the regulations to these areas nor to extend the regulations to other formula milks.