Written questions by Shannon.

What steps he is taking to (a) increase clinical and public awareness of small bacterial overgrowth symptoms and (b) ensure that patients with digestive problems receive the proper diagnosis and treatment.

In the diagnosis and treatment of digestive conditions like small intestine bacterial overgrowth (SIBO) we expect health professionals to take into account best practice guidance, including that published by the National Institute for Care Excellence (NICE) and professional organisations.In NICE’s Clinical Knowledge Summary on the assessment, investigation, and referral of chronic, which is more than four weeks' duration, diarrhoea in adults, health professionals are advised to consider SIBO when looking for features suggestive of an underlying cause such as systemic illness affecting gastrointestinal motility. The guidance is available at the following link:https://cks.nice.org.uk/topics/diarrhoea-adults-assessment/management/chronic-diarrhoea-more-than-4-weeks/The British Society of Gastroenterology provides resources and guidelines on SIBO, particularly in the context of irritable bowel syndrome (IBS). While not all individuals with IBS have SIBO, there's a significant overlap, with studies suggesting that up to 80% of IBS patients may also have SIBO. Additionally, the British Dietic Association provides resources and guidelines on dietary management for IBS, which can be relevant for SIBO due to the overlap in symptoms and potential dietary triggers.The NHS.UK website offers extensive information for the public on gut health, covering topics from digestive health tips and healthy eating for a healthy gut to specific conditions that are associated with SIBO including IBS, coeliac disease, and diverticular disease. The site provides advice on diet and managing common digestive issues. The national charity Guts UK also offers information, support, and resources for people with digestive health conditions, including on SIBO.The Getting it Right First Time gastroenterology programme aims to improve the diagnosis and management of digestive problems by streamlining referrals, promoting early specialist triage, and implementing proactive care. The programme focuses on ensuring that patients are seen by the right specialists promptly, leading to earlier diagnosis and more appropriate management of digestive issues.Additionally, community diagnostic centres (CDCs) offer a variety of diagnostic tests and scans for digestive problems, providing faster, more convenient access to diagnostic services closer to patients’ homes. NHS England is continuing to roll out CDCs, with additional capacity being delivered in 2025/26.

What steps his Department plans to take to build partnerships with (a) charities, (b) community organisations and (c) people with lived experience of cancer.

The Department is committed to engaging with charities, community organisations, and people with lived experience of cancer to make sure that the Government hears and learns from different voices to meet the challenges in cancer care in England.The forthcoming National Cancer Plan for England, due for publication in the second half of 2025, will have patients at its heart and will cover the entirety of the cancer pathway. The Department’s goal is to reduce the number of lives lost to cancer over the next 10 years, and the Department has sought the views of charities, community organisations, and people with lived experience of cancer to understand how we can do more to achieve this ambition.The Department also has the Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Programme, which is a mechanism through which the Department, NHS England, and UK Health Security Agency work together with VCSE organisations to: drive the transformation of health and care systems; promote equality; address health inequalities; and help people, families, and communities to achieve and maintain wellbeing.

When the NHS Long-Term Workforce Plan will be published; and what support he plans to provide to the community pharmacy workforce to deliver this plan.

We will publish our 10 Year Workforce Plan by the end of this year. The 10 Year Workforce Plan will replace the Long Term Workforce Plan with a more sustainable model. Instead of asking ‘how many staff do we need to maintain our current care model over the next 10 years?’, it will ask ‘given our reform plan, what workforce do we need, what should they do, where should they be deployed and what skills should they have?’.To support community pharmacy employers in developing their staff and delivering quality National Health Services, NHS England provides a number of funded national training opportunities for pharmacists and pharmacy technicians. This includes independent prescriber training, clinical examination skills, and training the next generation of education supervisors.

Whether he plans to increase funding within the Community Pharmacy Contractual Framework to help pharmacists deliver on their expanded roles under the 10-Year Health Plan.

As set out in the 10-Year Health Plan, community pharmacies will have a vital role in the Neighbourhood Health Service, working closely with other primary care providers at a neighbourhood level to deliver services.We expect services, including those that make use of pharmacist prescribing qualifications, to be commissioned both nationally, where that is most cost effective, and locally, to meet specific local needs and to support local populations. Commissioning arrangements and funding streams will vary depending on the service being commissioned and arrangements for local health provision.National commissioning of pharmacies includes vaccination and related services and the services commissioned through the Community Pharmacy Contractual Framework. As is custom and practice, we will consult Community Pharmacy England on the scope of those services and the funding available.

How the expanded Independent Prescribing and clinical services granted to community pharmacists in the 10-year health plan will be funded.

As set out in the 10-Year Health Plan, community pharmacies will have a vital role in the Neighbourhood Health Service, working closely with other primary care providers at a neighbourhood level to deliver services.We expect services, including those that make use of pharmacist prescribing qualifications, to be commissioned both nationally, where that is most cost effective, and locally, to meet specific local needs and to support local populations. Commissioning arrangements and funding streams will vary depending on the service being commissioned and arrangements for local health provision.National commissioning of pharmacies includes vaccination and related services and the services commissioned through the Community Pharmacy Contractual Framework. As is custom and practice, we will consult Community Pharmacy England on the scope of those services and the funding available.

What steps he is taking to ensure that the (a) pricing and (b) reimbursement system for multi-indication medicines is adequate for patients with (i) rare and (ii) ultra-rare conditions.

Indication-specific pricing can support access to treatments, including for rare conditions, by enabling companies to propose a specific price for smaller indications that would otherwise be commercially unviable under a uniform price.In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines, setting out their approach for assessing the eligibility of medicines with multiple indications to qualify for indication-specific pricing.The National Institute for Health and Care Excellence (NICE) has been able to recommend many medicines licensed for the treatment of rare and very rare diseases through its standard technology appraisal process which are now available to National Health Service patients in England. In addition, NICE operates a separate Highly Specialised Technologies evaluation programme for medicines that meet specific criteria for very rare conditions. This programme applies a higher cost-effectiveness threshold than standard appraisals to support access to treatments for very rare conditions.As set out in the Life Sciences Sector plan, we will be introducing a new and proportionate approach to NICE appraisals and NHS indication-specific based pricing agreements for medicines with large numbers of indications, strong long-term outcome data, and low affordability risk.The NHS Commercial Framework encourages early and open dialogue between companies and NHS England where indication-specific pricing or other commercial flexibilities may be needed to support access to treatments. NHS England is open to providing early guidance on such arrangements and to working with companies to explore suitable commercial options.

If he will make an assessment of the potential merits of requiring NHS England to establish an agreement in principle with pharmaceutical companies that commercial flexibility may be granted for a multi-indication medicine pending the outcome of the National Institute for Health and Care Excellence evaluation of such medicines.

Indication-specific pricing can support access to treatments, including for rare conditions, by enabling companies to propose a specific price for smaller indications that would otherwise be commercially unviable under a uniform price.In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines, setting out their approach for assessing the eligibility of medicines with multiple indications to qualify for indication-specific pricing.The National Institute for Health and Care Excellence (NICE) has been able to recommend many medicines licensed for the treatment of rare and very rare diseases through its standard technology appraisal process which are now available to National Health Service patients in England. In addition, NICE operates a separate Highly Specialised Technologies evaluation programme for medicines that meet specific criteria for very rare conditions. This programme applies a higher cost-effectiveness threshold than standard appraisals to support access to treatments for very rare conditions.As set out in the Life Sciences Sector plan, we will be introducing a new and proportionate approach to NICE appraisals and NHS indication-specific based pricing agreements for medicines with large numbers of indications, strong long-term outcome data, and low affordability risk.The NHS Commercial Framework encourages early and open dialogue between companies and NHS England where indication-specific pricing or other commercial flexibilities may be needed to support access to treatments. NHS England is open to providing early guidance on such arrangements and to working with companies to explore suitable commercial options.

With reference to the NHS commercial framework for new medicines, updated on 29 January 2025, what assessment he has made of the potential impact of the requirement to provide value at or below the National Institute for Health and Care Excellence cost-effectiveness threshold on access to treatments for (a) rare and (b) ultra-rare diseases.

Indication-specific pricing can support access to treatments, including for rare conditions, by enabling companies to propose a specific price for smaller indications that would otherwise be commercially unviable under a uniform price.In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines, setting out their approach for assessing the eligibility of medicines with multiple indications to qualify for indication-specific pricing.The National Institute for Health and Care Excellence (NICE) has been able to recommend many medicines licensed for the treatment of rare and very rare diseases through its standard technology appraisal process which are now available to National Health Service patients in England. In addition, NICE operates a separate Highly Specialised Technologies evaluation programme for medicines that meet specific criteria for very rare conditions. This programme applies a higher cost-effectiveness threshold than standard appraisals to support access to treatments for very rare conditions.As set out in the Life Sciences Sector plan, we will be introducing a new and proportionate approach to NICE appraisals and NHS indication-specific based pricing agreements for medicines with large numbers of indications, strong long-term outcome data, and low affordability risk.The NHS Commercial Framework encourages early and open dialogue between companies and NHS England where indication-specific pricing or other commercial flexibilities may be needed to support access to treatments. NHS England is open to providing early guidance on such arrangements and to working with companies to explore suitable commercial options.

How he plans to integrate the 10 Year Health Plan for England with the upcoming national cancer plan.

The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, research, and innovation. It will seek to improve every aspect of cancer care to better the experiences and outcomes for people with cancer. The National Cancer Plan will build on the three shifts set out by the 10-Year Health Plan. These shifts will enable rapid progress on the prevention, diagnosis, and treatment of cancer, as well as supporting those living with cancer to better manage their condition and improve their quality of life.The National Cancer Plan will aim to improve how the physical and psychosocial needs of people with cancer can be met, with a focus on personalised care to improve quality of life. It will address how the experience of care can be improved for those diagnosed, treated, and living with and beyond cancer.

What steps his Department plans to take to ensure that work undertaken by community pharmacists is not unnecessarily duplicated in neighbourhood health centres.

As set out in the 10-Year Health Plan, community pharmacies will have a vital role in the Neighbourhood Health Service, working closely with other primary care providers at a neighbourhood level and delivering more clinical services.What a Neighbourhood Health Service or Neighbourhood Health Centre looks like is best decided locally, depending on local needs. We expect that the skills of community pharmacists and their teams will be fully used by local commissioners and that community pharmacies will be provided with access to local phlebotomy pathways in those neighbourhoods where they are commissioned services that require blood tests.

If his Department will provide community pharmacists full access to phlebotomy pathways to help enable them to deliver their expanded roles as outlined in the 10 Year Health Plan for England.

As set out in the 10-Year Health Plan, community pharmacies will have a vital role in the Neighbourhood Health Service, working closely with other primary care providers at a neighbourhood level and delivering more clinical services.What a Neighbourhood Health Service or Neighbourhood Health Centre looks like is best decided locally, depending on local needs. We expect that the skills of community pharmacists and their teams will be fully used by local commissioners and that community pharmacies will be provided with access to local phlebotomy pathways in those neighbourhoods where they are commissioned services that require blood tests.

What steps his Department plans to take to ensure that the upcoming national cancer plan prioritises improving (a) patient experience and (b) quality of life.

The National Cancer Plan will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, research, and innovation. It will seek to improve every aspect of cancer care to better the experiences and outcomes for people with cancer. The National Cancer Plan will build on the three shifts set out by the 10-Year Health Plan. These shifts will enable rapid progress on the prevention, diagnosis, and treatment of cancer, as well as supporting those living with cancer to better manage their condition and improve their quality of life.The National Cancer Plan will aim to improve how the physical and psychosocial needs of people with cancer can be met, with a focus on personalised care to improve quality of life. It will address how the experience of care can be improved for those diagnosed, treated, and living with and beyond cancer.

What step his Department plans to take to build neighbourhood health services in partnership with (a) Macmillan and (b) other charities that have experience in (i) designing and (ii) delivering community-based services for people with long-term conditions.

The 10-Year Health Plan sets out our vision for neighbourhood health. The Neighbourhood Health Service will embody our new preventative principle that care should happen as locally as it can, digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and only in a hospital if necessary.We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, and they should be co-designed with communities and system partners. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need.Through our National Neighbourhood Health Implementation Programme, we will work with places across all systems to spread and scale up good practice and learning, create exemplars, and build the culture and capability required for delivery. This will be an inclusive, large-scale change programme for all system partners, including the voluntary, community, and social enterprise sector.The Department is developing the National Cancer Plan which will seek to foster improved collaboration with partners across the cancer ecosystem, including the voluntary and community sector. We will continue to work closely with Macmillan and other cancer partners as part of our engagement to inform the development of the plan.

What assessment his Department has made of the reasons for trends in the number of reported cases of measles in children; and what advice his Department has provided to parents whose children contract measles.

Coverage for all routine childhood immunisations, including the measles, mumps, and rubella (MMR) vaccine, has fallen in England over the last decade. National uptake of MMR1 in two-year-olds is currently 88.8%, and uptake of MMR1 and MMR2 in five-year-olds is 92.4% and 82.5% respectively. This is below the 95% needed to prevent measles outbreaks as recommended by the World Health Organisation.Falling vaccination rates have led to an increase of measles cases in England, with 2,911 laboratory confirmed measles cases in 2024. In response, a national MMR catch-up campaign was launched, which contributed to a downward trend in case numbers from mid-July, although small, localised outbreaks continued in some regions.The UK Health Security Agency, NHS England, and the Department will launch a new ‘always on’ vaccination campaign this summer to drive increased uptake of the routine maternal, childhood, and seasonal flu vaccinations. The MMR vaccine is a particular focus, with parents and carers of zero- to five-year-olds and pregnant women being two of the priority audiences for campaign activity.NHS England has provided detailed information for parents whose children have contracted measles, which can be found at the following link:https://www.nhs.uk/conditions/measles/The Department for Education also provides advice to parents, which is available at the following link:https://educationhub.blog.gov.uk/2024/03/what-to-do-if-you-think-your-child-has-measles-and-when-to-keep-them-off-school/

What steps he is taking to increase awareness of the potential risks of unregulated online pharmacies.

Pharmacies based in Great Britain must be registered with the General Pharmaceutical Council (GPhC). Patients can check if a pharmacy is registered on the GPhC website. The GPhC has recently updated their guidance for online pharmacies to strengthen their safeguards, to prevent people from receiving medicines that are not clinically appropriate for them, and which may cause them harm.Not all providers of medicines online are pharmacies registered with the GPhC. In such cases, the matter falls to the Medicines and Healthcare products Regulatory Agency (MHRA), which is responsible for regulating the sale, supply, and advertising of medicines which are set out in the Human Medicines Regulations 2012. These regulations apply equally to medicines advertised, sold, or supplied via the internet. The MHRA and its Criminal Enforcement Unit actively seeks to identify individuals involved in unlawful activity and, where appropriate, prosecutes those who put public health at risk.

What steps he is taking to support dementia patients with (a) memory loss and (b) other symptoms.

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.The Modern Service Framework for Frailty and Dementia will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.Those with dementia will also benefit from more joined up care through co-created care plans, and by 2027, 95% of those with complex needs will have an agreed care plan.

What steps he is taking to help prevent bullying amongst staff in health settings.

Bullying is unacceptable in any workplace and has no place in the National Health Service. All employers across the NHS should have a robust policy on bullying outlining how it should be handled and the support available to staff.As set out in the 10-Year Health Plan, the Government is committed to making the NHS the best place to work. We will publish a 10 Year Workforce Plan this autumn setting out how we will ensure all NHS staff are better treated, have better training, more fulfilling roles, and hope for the future, so they can achieve more.

What estimate he has made of the number of babies born with rare diseases in the first half of (a) 2025 and (b) 2024.

Working under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases. Digital data and technology are an underpinning theme of the UK Rare Diseases Framework. The National Disease Registration Service (NDRS) is part of NHS England and manages two disease registration services, including the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS). The NCARDRS records those people with congenital abnormalities and rare diseases across the whole of England. Further information on the NDRS and the NCARDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrshttps://digital.nhs.uk/ndrs/about/ncardrsCurrently, there is no single rare disease registry. The NDRS can access information from the Newborn screening programme, which enables early identification, referral, and treatment of babies with nine rare but serious conditions. The NDRS also approaches services for access to patient data for other rare conditions, but this is not blanket coverage at this stage. There are a number of rare diseases registries, some funded via NHS England, and some via industry or charities. Due to this, NDRS records would not be a full picture of everyone born with a rare disease.

What proportion of drug treatment services have fewer than 24 months of secured funding.

The Government is committed to ensuring that anyone with a drug or alcohol problem can access the help and support they need, and we recognise the need for greater certainty regarding funding and the ability to set clear budgets.Local authorities are responsible for assessing local need for alcohol and drug prevention and treatment in their area, and for commissioning services to meet these needs. It is also the responsibility of local authorities to set the length of the contracts with services.To better support upper tier and unitary local authorities’ vital public health work, from 2026/27 we will bring together over £4 billion of public health funding for local government, by consolidating service specific grants into the Public Health Grant. It is our intention to publish indicative Public Health Grant funding alongside the provisional Local Government Finance Settlement later this year, with final multi-year local authority Public Health Grant allocations published early in the new year. This will give local authorities more advanced notice of their total funding allocations, further empowering them to plan more effectively and better manage their services.Alongside the funding allocations, the Department and NHS England have also published a 10-year strategic plan for the drug and alcohol treatment and recovery workforce, from 2024 to 2034, which is the first national workforce plan for this specialist part of the health workforce in England and outlines key milestones to grow, train, and develop staff.

How many people across the UK have been hospitalised for opioid overdoses.

NHS England publishes data on hospital admissions and related diagnosis information, including finished admission episodes due to opioid overdoses.The total number of finished admission episodes in England relating to opium, heroin, or other opioids in 2023/24 was 6,582. Further data is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2023-24