Written questions by Shannon.

What recent discussions he has had with junior doctors on pay.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has met with the British Medical Association’s Resident, formerly Junior, Doctors Committee (BMA RDC) on several occasions to discuss a range of issues, including pay and working conditions. Most recently he met with the new BMA RDC leadership team on 13 October and subsequently has called the BMA RDC chair to try to avert strike action. Officials from the Department also maintain regular engagement with the BMA RDC.My Rt Hon. Friend, the Secretary of State for Health and Social Care made a written offer on 5 November to the British Medical Association Resident Doctors Committee (BMA RDC) which included measures to tackle bottlenecks in training, put money back in resident doctors' pockets and ensure that there is consistent implementation of existing contractual entitlements. Unfortunately, the BMA RDC rejected this just hours after being set out in a letter to them, instead choosing to proceed with the damaging strike action taken between 14-19 November.Resident doctors have received an average 28.9% pay increase since 2022/23, the highest public sector pay rise in the past two years. While the Government has been clear that there is no scope for further pay increases this year, we remain committed to working constructively with the BMA RDC to improve working conditions and support the long-term sustainability of the National Health Service’s workforce.

What steps he is taking to increase the number of funded women's health nursing training posts.

The Nursing and Midwifery Council (NMC) set the standards for nursing education in the United Kingdom. These standards prepare nurses to deliver care in a variety of roles and settings. There is no NMC-mandated requirement for post registration education for nurses working in women's health. It is the responsibility of individual employers to invest in the future of their workforce and to ensure specialist nurses have the appropriate ongoing training and continuing professional development to provide safe and effective care.

What steps he is taking to hire more GPs.

We are starting to see consistent growth in the general practitioner (GP) workforce. There was an overall increase of 440 full-time equivalent, or 1,298 headcount, doctors in GPs in September 2025 compared to September 2024.The Government committed to recruiting over 1,000 recently qualified GPs in primary care networks (PCNs) through a £160 million investment into the Additional Roles Reimbursement Scheme (ARRS) over 2024/25. This is part of our initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified GPs for which PCNs are claiming reimbursement via the ARRS show that, since 1 October 2024, over 2,500 GPs were recruited through the scheme.Newly qualified GPs employed under the ARRS will continue to receive support under the scheme in the coming year as part of the 2025/26 contract. Several changes have been confirmed to increase the flexibility of the ARRS. These include: GPs and practice nurses being included in the main ARRS funding pot; an uplift of the maximum reimbursable rate for GPs in the scheme; and no caps on the number of GPs that can be employed through the scheme.We are boosting practice finances by investing an additional £1,092 million in GPs to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is faster than the 5.8% growth to the NHS budget as a whole.

What assessment his Department has made of the potential merits of lowering the age at which women are offered their first smear test.

The cervical screening age in the United Kingdom was officially changed from 20 to 25 years old in 2003. This decision was made by the Advisory Committee on Cervical Cancer Screening which advised the NHS Cervical Screening Programme to raise the starting age due to evidence that screening younger women could do more harm than good. This is because: cervical abnormalities are common in women under 25 years old, but they usually resolve naturally; screening could lead to unnecessary treatments, which carry risks such as increased chances of pre-term delivery; and cervical cancer is extremely rare in women under 25 years old.Since then, the human papillomavirus vaccination programme has been introduced, which means the vast majority of women under 29 years old have been offered the vaccine that protects against most forms of cervical cancer.

What steps his Department is taking to help improve the diagnosis of arthritis in young people.

Healthcare in Northern Ireland is devolved, and is therefore a matter for the Northern Ireland Executive. In England, to support health and care professionals in the early diagnosis and management of arthritis, the National Institute for Health and Care Excellence has published expert guidance for both rheumatoid arthritis and osteoarthritis, which are available, respectively, at the following two links:https://www.nice.org.uk/guidance/ng100https://www.nice.org.uk/guidance/ng226The Royal College of General Practitioners also has a range of e-learning materials to support general practitioners and other primary care professionals in the diagnosis and management of arthritis, including a rheumatoid arthritis hub and an osteoarthritis hub, which are both available, respectively, at the following two links:https://elearning.rcgp.org.uk/course/view.php?id=496https://elearning.rcgp.org.uk/course/view.php?id=580We are working to deliver the Getting It Right First Time (GIRFT) Musculoskeletal Community Delivery Programme. GIRFT teams are working with integrated care board leaders to further reduce MSK community waiting times, including for young people with arthritis, and improve data and metrics, and referral pathways to wider support services.NHS England Specialised Commissioning has a Clinical Reference Group for specialised paediatric rheumatology, which has produced a service specification for these services. This service specification names juvenile idiopathic arthritis as one of the conditions that should be managed by a specialist paediatric rheumatology team. It also sets out that specialised paediatric rheumatology teams will provide transitional care to facilitate transfer and ongoing care in adult rheumatology. Transitional care planning will involve paediatric rheumatology teams, adult rheumatology teams and local hospitals under a shared care arrangement. Specialised paediatric rheumatology services are expected to be commissioned in line with this service specification.Our recently published 10-Year Health Plan outlines the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving arthritis care for young people in all parts of the country. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support young people, and their families to manage their long-term conditions, including arthritis, closer to home.

What steps his Department is taking to help find rare blood type donors.

NHS Blood and Transplant (NHSBT) is the organisation responsible for blood services in England. NHSBT works to find and encourage people with rare blood types to give blood to ensure blood of all types is available for patients when needed.In addition to routine extended antigen typing, which enables many rare donors to be identified, NHSBT’s Rare Donor Screening Programme tests approximately 25,000 donors annually, for additional blood group antigens, to identify donors with rare blood types. This testing helps to maintain a national rare donor panel containing extremely rare types.Furthermore, NHSBT’s Rare Donor Clinical Team contacts donors and actively manages their donation schedule via a special call up process. This team also works closely with hospitals to identify patients and their siblings as potential new donors. To ensure the timely availability of blood, blood from rare donors may also be frozen and stored in the National Frozen Blood Bank and thawed when required for patients.Finally, NHSBT also contributes to the International Rare Donor Panel which contains details of donors of rare blood types from 27 contributing countries and frozen unit inventories from frozen blood banks around the world. Further information on the International Rare Donor Panel is available at the following link:https://www.nhsbt.nhs.uk/ibgrl/services/international-rare-donor-panel/

Whether his Department plans to take steps with the primary eye care sector to help prevent avoidable sight loss.

Integrated care boards (ICBs) are responsible for assessing the health needs of their local population and commissioning primary and secondary eye care services to meet them.ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests play a crucial role in the early detection of a range of eye conditions and can help prevent avoidable sight loss.ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

Whether he plans to increase funding for primary eye care services as part of his Department's plan to shift care from hospitals to the community.

Over the course of the 10-Year Health Plan, the share of expenditure on hospital care will fall and there will be proportionally greater investment in out of-hospital care as local areas build and expand their neighbourhood health services.The detail of Spending Review budget allocations within departments is still being determined and we are working to provide the detail and certainty needed on future funding and spending plans.

What assessment his Department has made of trends in the availability of pancreatic cancer drugs.

The Department is aware of ongoing intermittent supply issues with pancreatic enzyme replacement therapy (PERT) used in the treatment of pancreatic cancer. We have been continuously assessing the availability of all PERT presentations for the duration of the supply disruption and implementing mitigation measures where there are any supply gaps. The Department is continuing to work with all suppliers of PERT to help resolve the supply issues in the short and longer term. Through these discussions we have managed to secure additional volumes for 2025 for the United Kingdom, and we are in regular communication with suppliers on expected volumes for 2026.The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market. We have widely disseminated comprehensive guidance to healthcare professionals, including National Health Service trusts, general practices, and pharmacies, about these supply issues, which provide advice on how to manage patients whilst there is disruption to supply. The Department will continue to work closely with the manufacturers to resolve the issues as soon as possible, to ensure patients have continuous access to medicines.The Department is also aware of a supply issue with mitomycin 10 milligram and 40 milligram powder for solution injection vials, a type of chemotherapy which may be used in the treatment of pancreatic cancer, which are out of stock until mid-January 2026. Alternative treatments have been sourced, and guidance has been issued to health care professionals with management advice until this issue is resolved.

What estimate his Department has made of the number of people who are out of work due to chronic arthritic pain.

We recognise the effect that poor health can have on economic inactivity and that the economy relies on a healthy population.The 10-Year Health Plan will support people with musculoskeletal (MSK) conditions like arthritis to better manage their condition and access services and support through the three shifts: from hospital to community; from analogue to digital; and from sickness to prevention. For example, the shift from hospital to community will enable people with MSK conditions to access a range of additional services to support the management of their condition and treatment closer to home.In line with this shift, the Government has funded NHS England’s Getting It Right First Time programme to deploy their proven Further Faster model for MSK community services. The programme has been designed to reduce waiting times for community MSK appointments and to enhance access to quality treatment, working with integrated care board leaders to improve data and metrics and referral pathways to wider support services.We are working together to further develop the approach to better enable integrated care systems to commission the delivery of high quality MSK services in the community, which will benefit patients now and into the future.Additionally, the Further Faster 20 scheme, which is an extension of the existing Further Faster Programme, is designed to help reduce waiting lists across multiple specialities at 20 targeted hospital trusts located in areas with the highest levels of economic inactivity.

When Baxdrostat will be available on the NHS.

In the United Kingdom, medicines need to have a licence before they can be marketed. These are granted by the Medicines and Healthcare products Regulatory Agency (MHRA). Licences confirm the health condition the medicine should be used for and the recommended dosage. To get a licence, the manufacturer of the medicine has to provide evidence which shows that the medicine is safe and effective enough to be used for a specific condition and for a specific group of patients, and that they can manufacture the medicine to the required quality.Newly licensed medicines are appraised by the National Institute for Health and Care Excellence (NICE), which is the independent body responsible for developing evidence-based guidance for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE aims wherever possible to issue draft guidance on new medicines close to the time of licensing. The NHS in England is legally required to fund drugs recommended by NICE, usually within three months of final guidance.Baxdrostat has not yet been licensed by the MHRA. If the manufacturer submits a request for a marketing authorisation, NICE will appraise baxdrostat to determine whether it can be recommended for routine use on the NHS and will aim to issue guidance as close as possible to licensing.

What assessment he has made of the potential impact of stress on Alzheimer's disease.

As highlighted in the Dementia Care Pathway: Full implementation guidance, poorly managed behavioural and psychological symptoms, which accompany dementia, may lead to increased distress, accelerated cognitive decline, inappropriate antipsychotic prescribing, unnecessary use of restraint, and earlier admission to residential care. This guidance is available at the following link:https://www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/dementia/nccmh-dementia-care-pathway-full-implementation-guidance.pdf?sfvrsn=cdef189d_8National Institute for Health and Care Excellence guidelines recommend, as initial and ongoing management, offering psychosocial and environmental interventions to reduce distress in people living with dementia.Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.

How he plans to integrate the 10-Year Plan with the National Cancer Plan.

The 10-Year Health Plan sets out how we will fight cancer on all fronts, from prevention to diagnosis to treatment, to improve survival and reduce the lives lost to one of the biggest killers. The National Cancer Plan for England will take forward this work and build on the shifts set out in the 10-Year Health Plan to improve the experiences and outcomes for people with cancer.

If he will take steps to increase the pay of band two phlebotomists.

Phlebotomists in England are paid on the Agenda for Change (AfC) pay scale which is underpinned by the Job Evaluation Scheme (JES). The JES is a structured method of comparing job demands as set out in the job documentation, for example the job description, to determine the appropriate AfC pay band for any given role.Employers are responsible for correctly and consistently implementing the JES locally to ensure staff are paid correctly for the work they are asked to deliver.Regarding AfC pay in general, the Government remitted the Pay Review Bodies on 22 July to begin the 2025 to 2026 pay round, with the target of getting uplifts into the pockets of health workers earlier next year.

If his Department will take steps to build neighbourhood health services in partnership with (a) Macmillan and (b) other charities.

The Department recognises the value of neighbourhood health services being built in partnership with voluntary organisations, such as Macmillan. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations.The Planning Framework for the National Health Service in England, published on 8 September, reiterates the commitment in the 10-Year Health Plan that place partners develop a local neighbourhood plan, which integrated care boards will bring together into a population health improvement plan. These local plans should set out how the NHS, local authority, and other organisations, including social care providers and the voluntary, community, and social enterprise (VCSE) sector, will work together to design and deliver neighbourhood health services. The Department will publish separate guidance to support their development in the autumn.The National Cancer Plan will build on the shift from hospital to community set out by the 10-Year Health Plan and will seek to foster improved collaboration with the VCSE sector to deliver this.This includes exploring how the impact economy can help deliver the goals set in the National Cancer Plan, collaborating across the Government, the NHS, civil society, and the corporate sector.

Whether he plans to introduce the use of AI to detect skin cancer.

Artificial intelligence (AI) offers a wide range of opportunities to help change our health and care system for the better. One opportunity for AI in the National Health Service is to support with diagnostics, including detecting skin cancer.The National Institute for Health and Care Excellence (NICE) routinely evaluates medical technologies, including innovative AI-enabled technologies, and makes recommendations on the clinical and cost-effectiveness of products for the health and social care services in England. NICE has recommended the use of an AI technology for assessing and triaging skin lesions for patients in the NHS suspected skin cancer pathway.This AI tool, DERM, can distinguish between benign and cancerous skin lesions with nearly 99.7% accuracy, and is now being used in 25 NHS trusts as a part of the NHS's rollout of ‘teledermatology’. Further evidence on the clinical and cost-effectiveness of the tool is currently being collected.

Whether he has had discussions with his Northern Ireland counterpart on introducing charge cards to support coeliacs in paying for gluten free alternatives.

No discussions between ministers and their counterparts in Northern Ireland on introducing charge cards to support coeliacs in paying for gluten free (GF) alternatives have been held.In the United Kingdom, healthcare is a devolved matter. Nearly all health and social care policy in Scotland, Wales, and Northern Ireland, including arrangements for coeliac patients, is handled by their respective administrations.Following a review in 2019, the position in England remains that GF bread and mixes can be provided to all eligible coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in Part XV of the Drug Tariff.

How many people aged between 18 and 25 have epilepsy.

This information is not held in the format requested. However, the following table shows a count of finished admission episodes (FAEs) and distinct patients where there is a primary diagnosis, or any diagnosis, of epilepsy, where the patient was aged 18 to 25 years old on admission, in 2024/25, in English National Health Service hospitals: Primary diagnosisAny diagnosisYearAdmissionsPatientsAdmissionsPatients2024/253,7172,70818,4099,839Source: Hospital Episode Statistics, NHS EnglandNotes:an FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes.  Admissions do not represent the number of patients, as a person may have more than one admission within the period;patient counts are based on the unique patient identifier. This identifier is derived from a patient’s date of birth, postcode, sex, local patient identifier, and NHS number, using a standard algorithm. Where data are incomplete, this identifier may wrongly link episodes or fail to recognise episodes for the same patient;the primary diagnosis is the first of up to 20 diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital;the number of episodes where this diagnosis was recorded in any of the 20 primary and secondary diagnosis fields in a HES record. Each episode is only counted once, even if a relevant diagnosis is recorded in more than one diagnosis field of the record; andfor the purposes of these data the following ICD-10 codes have been used: G40 - Epilepsy G41 - Status epilepticus. Please be aware that this data does not represent the total number of people aged between 18 and 25 years old who have a diagnosis of epilepsy. This data only represents the number of patients aged between 18 and 25 years old with epilepsy who required hospital admission in 2024/25. The data presented here will, therefore, only represent a small proportion of the total number of people aged between 18 and 25 years old who have a diagnosis of epilepsy.

What steps he is taking to raise awareness of sarcoma.

NHS England runs Help Us Help You campaigns in England to increase knowledge of cancer symptoms and to address the barriers to acting on them, to encourage people to come forward as soon as possible to see their general practitioner. The campaigns focus on a range of symptoms, as well as encouraging body awareness, to help people spot symptoms across a wide range of cancers, including sarcoma, at an earlier point.The National Cancer Plan will include further details on how the Department will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment. Having consulted with key stakeholders and patient groups, the plan will be published early in the new year. It will ensure that patients have access to the latest treatments and technology. The plan will seek to improve every aspect of cancer care, to improve the experiences and outcomes for people with cancer, including sarcoma.

How many sick notes have been issued by GPs in the last 12 months.

The sick note was replaced by the fit note in 2010. Since 2022, fit notes can be issued by doctors, registered nurses, occupational therapists, pharmacists, and physiotherapists.The latest data published by NHS England shows that out of the 10,974,495 fit notes issued electronically in primary care in England between January and December 2024, 9,898,344 were issued by general practitioners (GPs). This means that GPs issued 90.2% of these fit notes.Data is only available for fit notes issued electronically within primary care in England, meaning that paper fit notes or fit notes issued in hospitals are not included in these figures. The published statistics can be found at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/fit-notes-issued-by-gp-practicesUpdated figures will be published by NHS England on 23 October and will provide fit note data up to June 2025.