Written questions by Shannon.

What estimate he has made of the number of defibrillators in public spaces in England; and whether he has had recent discussions with his counterparts in the devolved Administrations on the number of defibrillators in public spaces across the UK.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The Department selected a joint bid from Smarter Society as its independent partners to manage grant applications. Smarter Society has reviewed funding applications, against requirements specified by the Department. The requirements are to ensure that resources are allocated to where there is the greatest need, for instance in remote communities with extended ambulance response times, and places with high footfall and high population.There have been no recent discussions with my counterparts in the devolved administrations on the number of defibrillators in public spaces. As of 1 March 2024, there were 86,337 defibrillators in the United Kingdom, with 68,509 in England, registered on The Circuit, the national defibrillator map operated independently by the British Heart Foundation.

How many people are on a waiting list for treatment for Tinnitus.

The Department does not hold information in this format. Tinnitus is a condition that can result in many different treatments, including medication, which are not all captured in the Waiting List Minimum Dataset.As of November 2024, the waiting list for ear, nose and throat (ENT) stood at 633,270. This marked a decrease of 4,380 compared to October 2024. As of November 2024, 49.2% of pathways were within 18 weeks. Not all of the patients on the waiting list will have a “decision to treat”.Tackling waiting lists, including in ENT, is a key part of our Health Mission, and we will deliver an additional two million operations, scans, and appointments during our first year in Government, which is equivalent to 40,000 per week, as a first step in our commitment to ensure that patients can expect to be treated within 18 weeks.The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS Constitutional Standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment by the end of this Parliament, whilst also ensuring that patients have the best possible experience of care. The Elective Reform Plan also commits to reforming clinical pathways to improve efficiency in five priority specialties, one of which is ENT.

What progress his Department has made on funding bowel cancer research.

Research is crucial in tackling cancer, which is why the Department invests over £1.6 billion per year in research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24. Cancer is a major area of NIHR spend, reflecting its high priority.Over the past five years, the NIHR has committed approximately £52 million across 57 bowel cancer research programmes. These include the FOCUS4 Trials Programme, which recruited over 1,500 patients at centres across the United Kingdom to evaluate how well tumour samples from patients with advanced stage bowel cancer may help select the best treatment for an individual patient, and the Translational Proteomic study, which uses primary tumour samples derived from patients, combined with the application of emerging technology, to understand the mechanisms of drug resistance in cancer cells to help better target anticancer drugs. Additionally, over this period the NIHR supported over 245 commercial and non-commercial clinical research studies into bowel cancer through the NIHR Research Delivery Network, allowing another 30,729 people to participate in potentially life-changing research in the National Health Service.The NIHR continues to encourage and welcome funding applications for research into any aspect of human health, including bowel cancer.

What assessment he has made of the potential impact of fizzy drinks on type 2 diabetes.

Scientific risk assessment and United Kingdom dietary recommendations are based on independent advice from the Scientific Advisory Committee on Nutrition (SACN).In 2015, the SACN published its report on Carbohydrates and Health and recommended that “the consumption of sugars-sweetened beverages should be minimised in children and adults”. With respect to type 2 diabetes, the SACN noted that “a greater risk is associated with a higher intake of sugars-sweetened beverages”. Energy intakes that consistently exceed requirements lead to weight gain and obesity in the long term.A 2014 Public Health England report found that adults living with obesity are five times more likely to be diagnosed with diabetes than adults of a healthy weight. Approximately 90% of adults with type 2 diabetes are living with overweight or obesity.The SACN is currently considering the World Health Organisation’s guideline on the use of non-sugar sweeteners and the associated systematic review, and whether additional assessment is required. The SACN is due to publish a position statement in 2025.

If she will make an estimate of recent trends in the number of people prescribed pain medication in the last 12 months.

The Prescription Cost Analysis data release gives items and quantities of each medicine dispensed in the community in England. The following table shows the total number of items dispensed for analgesics in England, regardless of where prescribed, as well as the unique number of patients that were dispensed medicines listed in British National Formulary (BNF) Section 4.7 Analgesics, from December 2023 to November 2024:Month and yearTotal number of itemsUnique identified patientsDecember 20235,000,0003,100,000January 20245,200,0003,200,000February 20244,800,0003,100,000March 20244,900,0003,100,000April 20245,100,0003,200,000May 20245,200,0003,200,000June 20244,800,0003,100,000July 20245,200,0003,200,000August 20245,000,0003,100,000September 20244,900,0003,100,000October 20245,200,0003,200,000November 20245,000,0003,200,000Total60,400,0007,500,000For further information, BNF 4.7 includes:- non-opioid analgesics and compound preparations;- opioid analgesics;- neuropathic pain medicines; and- antimigraine medicines.No data has been captured relating to the clinical indication a prescription is intended for. Some of these products can be used for a variety of clinical indications and therefore the figures provided may include items that were prescribed for a different condition, rather than for pain relief.It is important to note that this data does not capture medicines classified elsewhere within the BNF, which are primarily used for other reasons, but may also be used for analgesic purposes. This includes, for example, non-steroidal anti-inflammatory drugs, which feature in 10.1 ‘Drugs used in rheumatic diseases and gout’, and antidepressants, used off-label in chronic primary pain, which feature in 4.3 ‘Antidepressant drugs’.

What comparative assessment he has made of the level of uptake of the flu vaccine in (a) 2024 and (b) the last five years for which data is available.

The UK Health Security Agency publishes provisional monthly data on flu vaccine uptake in England in eligible patient groups, with further information available at the following link: https://www.gov.uk/government/collections/vaccine-uptake#seasonal-flu-vaccine-uptake:-figuresThe following table shows the percentage of general practice patients with vaccination coverage, broken down by patient groups, from 2019/20 to 2024/25:Patient groupOver 65 years oldAt riskPregnant womenTwo year oldsThree year olds2024/2573.8%38.6%33.7%40.9%42.4%2023/2477.0%40.3%30.9%41.0%41.3%2022/2378.4%46.3%33.2%39.8%42.2%2021/2281.5%49.3%37.3%46.6%49.1%2020/2180.2%51.5%43.0%54.1%56.5%2019/2070.6%40.8%41.3%37.0%36.9% In addition, the following table shows the percentage of school aged children and frontline health care workers in England with vaccination coverage, from 2019/20 to 2024/25: Primary school, from Reception to Year 6Secondary schoolFrontline health care workers2024/2554.0%44.0%36.2%2023/2453.8%41.2%41.0%2022/2355.5%10.3%46.7%2021/2252.9%37.8%58.8%2020/2159.8%53.5%75.3%2019/2057.9%N/A68.5%Note: for secondary school pupils, the eligible year groups varied by season, and so for the years 2024/25, 2023/24, and 2021/22 the data covers those from Year 7 to Year 11, but for 2022/23 it only covers those from Year 7 to Year 9, and for 2020/21, it just includes those in Year 7.Caution should be used when comparing flu vaccine uptake between seasons. In 2024/25, adult groups, excluding pregnant women, were eligible from 3 October, rather than 1 September, as in previous seasons. Therefore, vaccine uptake data for this season is not comparable to previous seasons in these groups. In addition, the roll out to secondary school aged children has not been uniform, in some years not all of those in Year 7 to Year 11 were offered the vaccine.

What assessment he has made of the potential merits of developing a national strategy to place defibrillators in high need areas.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The Department selected a joint bid from Smarter Society as its independent partners to manage grant applications. Smarter Society has reviewed funding applications, against requirements specified by the Department. These requirements were to ensure that resources are allocated where there is the greatest need, for instance remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest, including sporting venues and venues with vulnerable people, and deprived areas.As part of the Department’s requirements, the defibrillators are suitable for use by untrained persons. The Mindray C1A Defibrillator, a fully automated device suitable for use by untrained persons, are the AEDs provided by Smarter Society in partnership with London Hearts charity.The Department has continued its partnership with Smarter Society, who managed the grant applications on our behalf, with London Hearts supplying the AEDs. London Hearts is the leading heart defibrillator charity in the United Kingdom, supporting communities with the provision of life saving heart defibrillators and teaching cardiopulmonary resuscitation and defibrillator skills.NHS England has partnered with St John Ambulance to co-ordinate skills development to significantly increase the use of AEDs by individuals in community settings. This includes a national network of Community Advocates to champion the importance of first aid, training 60,000 people that will help save up to 4,000 lives each year by 2028.

What the cost to the NHS is of (a) surgery to transplant a kidney and (b) medication for a year for a kidney transplant recipient.

NHS Blood and Transplant (NHSBT) is responsible for transplant services across the United Kingdom. Transplants represent a cost-efficient treatment and in the case of kidneys is a cost saving to the National Health Service.The following table shows the estimated national average unit cost of a kidney transplant for 2023/24 for people aged 19 years old and over:Donor categoryCost (£)Deceased heart-beating donor18,508Deceased non-heart beating donor21,418Live donor17,473Source: NHSBTThe cost to the NHS of medication for a kidney transplant recipient for the first year after transplant can range on average between £9,000 and £13,000. Following this, costs can range on average between £5,000 and £8,000 per patient per year. These estimated costs are based on British National Formulary list price. For some drugs, the NHS can access confidential prices that cannot be shared outside of the NHS. The average cost does not take into consideration additional treatments in the event of complications such as infections and post-transplant rejections.

What the average cost per patient for (a) in centre and (b) home therapies dialysis treatment was in each of the last three years.

The national average patient cost for home-based renal dialysis for the last three years was £280 in 2023/24, £231 in 2022/23, and £213 in 2021/22. The national average patient cost for hospital-based renal dialysis for the last three years was £223 in 2023/24, £220 in 2022/23, and £192 in 2021/22.

What assessment he has made of the potential merits of Elacestrant.

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether new medicines should be routinely funded by the NHS based on an assessment of their costs and benefits. The NHS is legally required to fund medicines recommended by the NICE, and cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of positive NICE draft guidance.The NICE recommended elacestrant as an option for treating oestrogen receptor-positive, HER2-negative advanced breast cancer with an ESR1 mutation after endocrine treatment in final draft guidance on 19 December 2024, and it is now funded for eligible patients in England through the Cancer Drugs Fund. Final guidance is due to publish on 5 February 2025.

How many alcohol related deaths there have been in England in the last 12 months.

There were 21,912 alcohol-related deaths in England for the 2022 calendar year. This is from the latest available data, published by the Department, and is available at the following link:https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/4/gid/1938132984/pat/159/par/K02000001/ati/15/are/E92000001/iid/93763/age/1/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1The data for 2023 will be published on 4 February 2025.

What assessment he has made of the implications for his policies of trends in the uptake of IVF in the last five years.

The Human Fertilisation and Embryology Authority published its Fertility Trends analysis in July 2024, based on the previous four years’ worth of data. The analysis is available at the following link:https://www.hfea.gov.uk/about-us/publications/research-and-data/fertility-treatment-2022-preliminary-trends-and-figures/This document has helped inform the Department’s work with NHS England to consider future policy options to support integrated care boards to provide more equitable in-vitro fertilisation services.

What discussions he has had with his counterpart in Northern Ireland on funding research through public health agencies.

The Department works closely with all of the devolved administrations on shared research interests. The Department has an arrangement with the devolved administrations that allows research hosts, including universities and research active National Health Service organisations, in the devolved administrations to apply for National Institute for Health and Care Research funding, due to funding contributions from the Northern Irish, Scottish and Welsh administrations. These arrangements are in place due to consultation between the Department of Health and Social Care, the Scottish Government’s Chief Scientist Office, Health and Care Research Wales, and Health and Social Care Research and Development in Northern Ireland. In support of this, the Department has regular discussions with senior officials in the devolved administrations on health and social care research.

What assessment he has made of recent trends in the level of diagnosis for rheumatoid arthritis.

No specific assessment has been made of recent trends in the level of diagnosis for rheumatoid arthritis in England. In 2023/24, 0.8% of patients in England aged 16 years old and older had a diagnosis of rheumatoid arthritis recorded on the practice disease register. Therefore, there are estimated to be approximately 460,000 people with a diagnosis of rheumatoid arthritis in England. This data is from the Fingertips data collection and is based on the Quality and Outcomes Framework, with further information available at the following link:https://fingertips.phe.org.uk/profile/msk/data#page/4/gid/1938133186/ati/15/iid/91269/age/164/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/tre-do-0.The percentage of patients with rheumatoid arthritis has remained fairly stable since the Fingertips data on rheumatoid arthritis was first collected in 2013/14. In 2013/14, 0.7% of patients in England aged 16 years old and older had a diagnosis of rheumatoid arthritis recorded on the practice disease register.

What assessment he has made of the adequacy of waiting lists for prostate cancer diagnosis.

No assessment has been made of the adequacy of waiting lists for prostate cancer. However, we know that patients, including those with suspected prostate cancer, are waiting too long for diagnosis. We will get the National Health Service diagnosing cancer on time or earlier, treating it faster, and we will improve patients’ experience across the system.As we set out in our new plan for reforming elective care, we are committed to improving performance on cancer waiting times. Further details will be set out in a dedicated national cancer plan and the NHS’s annual operational planning guidance.

What safeguards are in place to manage the use of AI in the NHS.

There are strict safeguards in place throughout the National Health Service to protect data. All providers of services which handle patient data must protect that data in line with UK General Data Protection Regulations, and the Data Protection Act 2018, and every health organisation is required to appoint a Caldicott Guardian to advise on the protection of people’s health and care data, and ensure it is used properly. This includes where artificial intelligence (AI) is used in relation to patient records.The NHS AI Lab and Sciencewise, which is funded by UK Research and Innovation, held a public dialogue on how the public feels decisions should be made about access to their personal health data for AI purposes. The NHS AI Lab conducted a discovery exercise to design approaches based on insights from the public, which is now informing broader data stewardship initiatives, for example as part of the Secure Data Environments.To mitigate the likelihood and severity of any potential harm to individuals arising from use of data in AI, the Information Commissioners Office has developed detailed AI guidance which provides an overarching view of data protection, including Data Protection Impact Assessments and UK General Data Protection Regulations. They have also produced an AI toolkit to support organisations auditing compliance of their AI-based technologies.

What steps he is taking to help increase public awareness on the prevention of liver cancer.

NHS England runs Help Us Help You campaigns in England to increase knowledge of cancer symptoms and address 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 at an earlier point.NHS England and other National Health Service organisations, nationally and locally, publish information on the signs and symptoms of many different types of cancer, including liver cancer. This information can be found at sources like the NHS.UK website, which is available at the following link:https://www.nhs.uk/

What his planned timetable is for the rollout of Durvalumab for the treatment of bladded cancer.

The National Institute for Health and Care Excellence (NICE) makes recommendations on whether new medicines should be funded by the National Health Service based on their costs and benefits. Wherever possible, NICE aims to align its processes with the regulatory process so that final guidance is published at, or around, the time that the treatment is granted a licence. The NHS in England is required to fund treatments recommended by NICE, normally within three months of guidance, and cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of a positive draft recommendation.NICE has four relevant technology appraisals in development or awaiting development currently: Durvalumab for neoadjuvant and adjuvant treatment of muscle-invasive bladder cancer, with development expected to start in April 2025 and earliest publication date February 2026; Durvalumab with enfortumab vedotin for neoadjuvant and adjuvant treatment of muscle-invasive bladder cancer when cisplatin is unsuitable, with development expected to start in October 2026 and earliest publication date August 2027; Durvalumab with Bacillus Calmette-Guerin (BCG) for treating high-risk non-muscle-invasive bladder cancer after resection of papillary tumours in people previously untreated with BCG, with timelines for this appraisal still to be confirmed as NICE is awaiting an update from the company regarding its preferred submission date; and Durvalumab with tremelimumab and chemotherapy for treating unresectable or advanced urothelial cancer, with development expected to start in January 2026 and earliest publication date October 2026.

If he will make an assessment of the effectiveness of the severe asthma service specification in ensuring eligible severe asthma patients are able to access biologic medicines.

NHS England’s current severe asthma service specification is being revised by the Specialised Respiratory Clinical Reference Group. The revised specification will support the management of patients who require further investigation and treatments, including biological medicines. The specification will also be updated to reference the most recent clinical guidelines such as the British Thoracic Society, the National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network’s asthma guideline, covering diagnosing, monitoring, and managing asthma in adults, young people, and children. It is expected to improve outcomes for people with asthma and identify early those who require further investigation and treatments, including biologic medicines. Eligibility for biologics is governed by the NICE’s Technology Appraisals, which make recommendations for the National Health Service on whether treatments represent a clinically and cost-effective use of NHS resources. The NHS in England is legally required to fund NICE-recommended treatments.

Pursuant to the Answer of 2 December 2024 to Question 15751 on Chronic Obstructive Pulmonary Disease: Health Services, when he expects NHS England to finalise the development of their approach for COPD; and when this approach will be made public.

Respiratory diseases, including chronic obstructive pulmonary disease (COPD), are a clinical priority within the NHS Long Term plan and the National Health Service is investing in the provision of more and better rehabilitation services for respiratory patients. This has the objective of improving outcomes for people with COPD through early diagnosis and increased access to treatments. NHS England has established 13 Respiratory Clinical Networks across the country. These have been vital in providing clinical leadership for respiratory services and supporting services in primary care, including restoring spirometry, which is one of the tests used to diagnose COPD.The NHS RightCare COPD pathway has been rolled out nationally and defines the optimal service for people with COPD. Furthermore, the National Respiratory Audit Programme aims to improve the quality of care, services, and clinical outcomes for patients with asthma and COPD, by collecting and providing data on a range of indicators and pulmonary rehabilitation activity.A national programme of work is underway to support systems with improving access to pulmonary rehabilitation for the eligible population, increase the capacity of provision to reduce waiting lists, and improve the quality and consistency of rehabilitation programmes through accreditation. Pulmonary rehabilitation is effective for people with COPD, improving exercise capacity or increasing quality of life in 90% patients who complete a programme. National Respiratory Audit Programme data shows that the number of people completing pulmonary rehabilitation in 2023/24 exceeded pre-pandemic levels, an important milestone in the post pandemic service recovery objective.NHS England is leading on the development of an approach for COPD management to support the proactive identification and management of rising risk patients in winter, to reduce demand on primary and secondary care. The approach fully aligns with a Neighbourhood Health Service model and includes the identification of rising risk patients, optimisation of care, support, and management, through remote monitoring, and a greater focus on self-management and education, as well as access to strengthened support in the community.The plan is to test and evaluate this approach in four sites this winter, recognising that many other services in the country already implement some of the elements of the approach described, to help inform decisions on winter planning in the future. In Hull and East Yorkshire, one of the selected sites, where this service has been studied in patients following severe COPD exacerbations, patients using this service had significantly fewer emergency department attendances and hospital admissions at three-months, compared with a historical control cohort.