Written questions by Shannon.

What steps his Department is taking to reduce chronic obstructive pulmonary disease mortality.

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.

What steps his Department is taking to reduce emergency admissions for chronic obstructive pulmonary disease.

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.

What steps his Department is taking to improve the diagnosis of primary biliary cholangitis (a) overall and (b) in women.

The Government is committed to improving the lives of those living with rare diseases, including non-genetic rare diseases such as primary biliary cholangitis. The UK Rare Diseases Framework sets out four priorities, collaboratively developed with the rare disease community, to help patients get a final diagnosis faster, increase awareness of rare diseases amongst healthcare professionals, better coordinate care, and improve access to specialist care, treatment, and drugs. All four nations of the United Kingdom have published action plans setting out how these priorities will be delivered. We remain committed to delivering under the framework and will publish our fourth annual England action plan in 2025, which will report on progress. Actions include research to improve our understanding of the diagnostic journey and the development of innovative digital resources, making information on rare conditions easily available to healthcare professionals, including general practitioners. Continued development of educational resources through the NHS England Rare Disease Education Hub is helping to increase health care professionals’ awareness of rare conditions.

What steps he is taking to increase (a) awareness and (b) understanding of primary biliary cholangitis among (i) general practitioners and (ii) other healthcare professionals.

The Government is committed to improving the lives of those living with rare diseases, including non-genetic rare diseases such as primary biliary cholangitis. The UK Rare Diseases Framework sets out four priorities, collaboratively developed with the rare disease community, to help patients get a final diagnosis faster, increase awareness of rare diseases amongst healthcare professionals, better coordinate care, and improve access to specialist care, treatment, and drugs. All four nations of the United Kingdom have published action plans setting out how these priorities will be delivered. We remain committed to delivering under the framework and will publish our fourth annual England action plan in 2025, which will report on progress. Actions include research to improve our understanding of the diagnostic journey and the development of innovative digital resources, making information on rare conditions easily available to healthcare professionals, including general practitioners. Continued development of educational resources through the NHS England Rare Disease Education Hub is helping to increase health care professionals’ awareness of rare conditions.

What plans his Department has to improve patient care for (a) primary biliary cholangitis and (b) other non-genetic rare diseases.

The Government is committed to improving the lives of those living with rare diseases, including non-genetic rare diseases such as primary biliary cholangitis. The UK Rare Diseases Framework sets out four priorities, collaboratively developed with the rare disease community, to help patients get a final diagnosis faster, increase awareness of rare diseases amongst healthcare professionals, better coordinate care, and improve access to specialist care, treatment, and drugs. All four nations of the United Kingdom have published action plans setting out how these priorities will be delivered. We remain committed to delivering under the framework and will publish our fourth annual England action plan in 2025, which will report on progress. Actions include research to improve our understanding of the diagnostic journey and the development of innovative digital resources, making information on rare conditions easily available to healthcare professionals, including general practitioners. Continued development of educational resources through the NHS England Rare Disease Education Hub is helping to increase health care professionals’ awareness of rare conditions.

What the cost to the public purse is of hospital repairs over the last 12 months.

The total cost of hospital repairs in England is collected by NHS England’s Estates Returns Information Collection (ERIC) for each financial year.The latest ERIC data, for the 2023/24 financial year, showed that capital investment reported by National Health Service trusts for changing and improving existing buildings totalled £1,718,500,000, whilst capital investment for maintaining existing buildings totalled £738,600,000. The published version of this dataset is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2023-24.Capital investment for repairing NHS hospitals occurs throughout the financial year based on engagement with individual NHS organisations. In this context, cost data for months that fall during the 2024/2025 financial year is not finalised as the financial year is not yet complete, making this the most recent 12 months of data available.

What steps he is taking to help tackle addiction issues in under 18s.

The most effective and sustainable approach to tackling addiction in children and young people is by giving them the best start in life and by keeping them safe, well, and happy. Our mission-based approach will ensure that every child has the best start in life and that we create the healthiest generation of children ever.Statutory guidance on relationships, sex, and health education requires all primary and secondary schools to ensure that pupils know the key facts and risks associated with alcohol and drug use, smoking, vaping, and gambling, as well as how to manage influences and pressure, and to keep themselves healthy and safe.The Department has worked with the Personal, Social, Health and Economic Education Association to develop the lesson plans on alcohol and drugs, and has commissioned an update of the resources to be published later this year. Further information is available at the following link:https://pshe-association.org.uk/drugeducationThe Government also has an alcohol and drug information and advice service called Talk to FRANK, which aims to reduce alcohol and drug use and its harms by providing awareness to young people, parents and concerned others. Further information on Talk to FRANK is available at the following link:https://www.talktofrank.com/In addition to the Public Health Grant, the Department allocated local authorities £267 million in 2024/25 to improve the quality and capacity of drug and alcohol treatment and recovery, which includes funding for services for children and young people with, or at risk of developing, alcohol and/or drug problems. Future targeted funding for drug and alcohol treatment services beyond 2025 will be announced very shortly.The Government is providing £70 million of additional funding for local authority-led Stop Smoking Services in England in 2024/25, which includes adults and under 18 year olds, building on existing funding made available via the Public Health Grant. The Government will also provide a further £70 million of funding for Stop Smoking Services in 2025/26.While vaping can be an effective way for adult smokers to quit smoking, children should never vape. The Tobacco and Vapes Bill will break the cycle of addiction and protect children from future harm by banning the advertising and sponsorship of vaping and nicotine products, and will provide powers to regulate their flavours and packaging, and will change how and where they are displayed in shops. The bill will bring about definitive and positive change to stop future generations from becoming hooked on nicotine. It will create the first smoke-free generation, and will ensure that children turning 16 years old this year or younger can never legally be sold tobacco.The Government is committed to reducing gambling-related harm through regulatory reform to strengthen protections. We continue to work with Department for Digital, Culture, Media and Sport, the National Health Service, and other delivery partners to consider how best to achieve this. Since 2019, treatment and support for under 18 year old’s experiencing gambling-related harm has been available through the NHS National Gambling Clinic.

What progress he has made on GP online booking services.

We want to ensure general practice (GP) online booking services are available to those who need them. That’s why we have committed to implementing a modern appointment booking system, designed to eliminate the 8:00am rush for appointments. All practices in England are required to offer online and video consultation tools, secure electronic communication methods, and online facilities to provide and update personal information.Subject to consultation with the British Medical Association, the Government proposes requiring GPs to be accessible to patients via electronic communications throughout core hours, as well as over the phone, helping more people book an appointment or speak to a GP, and supporting the Government’s aim to shift care from analogue to digital.99.4% of the primary care estate are now live with digital telephony and 90% have been enrolled to use online registration systems.

What steps he is taking to increase awareness of the warning signs of lobular breast cancer.

NHS England runs Help Us Help You campaigns to increase the 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, including symptoms of lobular breast cancer, as well as encouraging body awareness, to help people spot symptoms across a wide range of cancers at an early point.NHS England and other National Health Service organisations, nationally and locally, also publish information on the signs and symptoms of many different types of cancer, including lobular breast cancer. Further information can be found on the NHS.UK website.

What steps he is taking to tackle delays to care packages.

Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market and to commission services to meet the diverse needs of all local people. In performing that duty, a local authority must have regard to current and likely future demand for such services, and consider how providers might meet that demand.The Government has announced that a revised policy framework for the Better Care Fund in 2025/26 will shortly be published. This will outline redefined goals that emphasise its commitment to shifting care from hospital to home, and from sickness to prevention.The Government is supporting local authorities by making up to £3.7 billion of additional funding available for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

How many organs were donated for transplant in 2024.

The following table shows the number of organs donated, the number of donors, and the number and percentage of organs donated that were transplanted, from the UK Transplant Registry, between 1 January 2024 and 31 December 2024, as of 10 January 2025:United Kingdom solid organ donor typeNumber of donorsOrgans donatedOrgans transplantedLiving donors938938938 (100%)Deceased donors1,3854,5133,787 (84%)Note: there are many reasons why organs cannot be transplanted, including the organ being clinically unsuitable.Figures are subject to change due to the delayed notification of living organ donor transplants and the current proximity to the end of 2024.

What assessment he has made of the adequacy of the time taken to diagnose (a) mouth and (b) throat cancer.

No specific assessment has been made on the adequacy of mouth and throat cancer diagnosis waiting times.However, it is a priority for the Government to support the National Health Service to diagnose cancer as early and quickly as possible, to treat it faster, and ultimately to improve outcomes.The Department is committing to improving waiting times for cancer treatment, starting by delivering an extra 40,000 operations, scans, and appointments each week, to support faster diagnosis and access to treatment.

What assessment his Department has made of the adequacy of the Medicines and Healthcare products Regulatory Agency guidance on the use of medicinal cannabis.

Rules around the electronic prescribing of cannabis-based medicines are no different to other drugs regulated in Schedule 2 to 5 of the Misuse of Drugs Regulations 2001.In England, the NHS Electronic Prescription Service (EPS) enables the electronic transmission of prescriptions for Schedule 2 to 5 controlled drugs. As part of the robust system of governance and restrictions around the most addictive and harmful drugs, all private healthcare provider prescriptions for Schedule 2 and 3 controlled drugs cannot be transmitted by electronic means and must be issued on a paper FP10PCD prescription form. All paper copies of private prescriptions of Schedule 2 and 3 controlled drugs must be submitted to the NHS Business Services Authority. NHS England Controlled Drug Accountable Officers have a statutory duty to monitor the management and use of controlled drugs in the National Health Service and private healthcare.Similar legislative and governance arrangements are in place in Northern Ireland concerning the management and use of controlled drugs. All private prescribing of Schedule 2 and 3 controlled drugs must be issued on a paper PCD1 prescription form, which, once dispensed, are submitted to the Business Services Organisation, in line with requirements in the Misuse of Drugs (Northern Ireland) Regulations 2002. There is currently no electronic transmission of prescriptions in primary care in Northern Ireland.The Medicines and Healthcare products Regulatory Agency (MHRA) does not provide guidance on the use of medicinal cannabis. The MHRA provides guidance on manufacturing, importing, distributing, and supplying unlicensed medicines, which includes cannabis-based products for medicinal use in humans.Current guidelines on the prescribing and use of cannabis-based medicinal products, specifically guideline NG144, are published on the National Institute for Health and Care Excellence website, which is available at the following link:https://www.nice.org.uk/The guidelines have been endorsed by the Department of Health in Northern Ireland as applicable within Health and Social Care in Northern Ireland. The National Institute for Health and Care Excellence develops its guidance independently and keeps its published guidelines under active surveillance, so that it is able to update its recommendations in light of any significant new evidence.

What assessment his Department has made of the adequacy of restrictions on the use of electronic prescriptions for the issuing of medicinal cannabis products.

Rules around the electronic prescribing of cannabis-based medicines are no different to other drugs regulated in Schedule 2 to 5 of the Misuse of Drugs Regulations 2001.In England, the NHS Electronic Prescription Service (EPS) enables the electronic transmission of prescriptions for Schedule 2 to 5 controlled drugs. As part of the robust system of governance and restrictions around the most addictive and harmful drugs, all private healthcare provider prescriptions for Schedule 2 and 3 controlled drugs cannot be transmitted by electronic means and must be issued on a paper FP10PCD prescription form. All paper copies of private prescriptions of Schedule 2 and 3 controlled drugs must be submitted to the NHS Business Services Authority. NHS England Controlled Drug Accountable Officers have a statutory duty to monitor the management and use of controlled drugs in the National Health Service and private healthcare.Similar legislative and governance arrangements are in place in Northern Ireland concerning the management and use of controlled drugs. All private prescribing of Schedule 2 and 3 controlled drugs must be issued on a paper PCD1 prescription form, which, once dispensed, are submitted to the Business Services Organisation, in line with requirements in the Misuse of Drugs (Northern Ireland) Regulations 2002. There is currently no electronic transmission of prescriptions in primary care in Northern Ireland.The Medicines and Healthcare products Regulatory Agency (MHRA) does not provide guidance on the use of medicinal cannabis. The MHRA provides guidance on manufacturing, importing, distributing, and supplying unlicensed medicines, which includes cannabis-based products for medicinal use in humans.Current guidelines on the prescribing and use of cannabis-based medicinal products, specifically guideline NG144, are published on the National Institute for Health and Care Excellence website, which is available at the following link:https://www.nice.org.uk/The guidelines have been endorsed by the Department of Health in Northern Ireland as applicable within Health and Social Care in Northern Ireland. The National Institute for Health and Care Excellence develops its guidance independently and keeps its published guidelines under active surveillance, so that it is able to update its recommendations in light of any significant new evidence.

How many people in the UK have been diagnosed with sepsis in the last 12 months.

There is a lack of reliable estimates of the incidence and prevalence of sepsis, due to the inconsistency in the definitions used to describe sepsis, and the differences in coding between professionals and organisations in the United Kingdom.The Office for National Statistics (ONS) publishes data on the number of death registrations where sepsis was the underlying cause of death, and where sepsis was mentioned anywhere on the death certificate, for England and Wales between 2001 and 2023. According to the ONS, in 2023, the number of deaths registered where sepsis was mentioned anywhere on the death certificate in England and Wales was 26,203. The ONS has not yet published the number of death registrations for sepsis for 2024. The published ONS data for deaths involving sepsis is available at the following link:https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/adhocs/2111deathsinvolvingsepsisenglandandwales2001to2023The Department continues to work with NHS England and the UK Health Security Agency to improve our understanding of sepsis data and to monitor trends in infection incidence and deaths from sepsis, which are complex and multifactorial.

What assessment he has made of the potential implications for his policies of trends in levels of people diagnosed with dementia over the last five years.

The national target is for 66.7% of people estimated to be living with dementia to receive a formal diagnosis. The latest dementia diagnosis rate reported by NHS England for the end of November 2024 was 65.8%.The target had been met consistently at the national level from July 2016 until end of March 2020, when it dropped due to the COVID-19 pandemic, as memory services were reduced in capacity and general practitioner referrals into these services decreased significantly. At a national level, the dementia diagnosis rate is now gradually recovering due to sustained efforts.NHS England continue to monitor the monthly dementia diagnosis rate and analyse trends at national, regional, and integrated commissioning board (ICB) level.  This provides a clear direction for ICBs to support delivery of timely diagnoses within local systems and enable access to appropriate post diagnostic support.

What assessment he has made of the adequacy of ambulance waiting times over the 2024-25 Christmas and new year period.

Ambulance response times have been below the high standards that patients should expect in recent years. The Government has committed to supporting the National Health Service to improve performance and achieve the standards set out in the NHS Constitution, including ambulance response times.The following table shows the national ambulance response time performance in December 2024 for Category 1, 2, 3 and 4 incidents, in hours, minutes and seconds:Category of incidentDecember 2024 national averageNHS constitution standardCategory 1 – average response time00:08:4000:07:00Category 1 – 90th centile response time00:15:2500:15:00Category 2 – average response time00:47:2600:18:00Category 2 – 90th centile response time01:41:4000:40:00Category 3 – 90th centile response time07:21:0302:00:00Category 4 – 90th centile response time08:15:4403:00:00Source: NHS England Ambulance Quality Indicators (https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/)

Whether he has had recent discussions with the British Medical Association on its response to the Cass review.

My rt. Hon. Friend, the Secretary of State for Health and Social Care, met with the Chair of the British Medical Association (BMA), on 31 July 2024, where the BMA’s response to the Cass Review was raised.While we respect the BMA’s right to undertake an evaluation of the Cass Review, we do not think it is necessary. The Cass Review is robust, evidence-based, and the most comprehensive assessment of gender incongruence in children and young people that has been produced to date. The Government and NHS England are committed to implementing the Cass Review in full.NHS England’s ambitious two-year action plan sets out how it will continue to transform and improve services, helping to tackle waiting lists while ensuring safe and holistic care.

What assessment his Department has made of the adequacy of the number of spirometry tests carried out in Community Diagnostic Centres.

NHS England continues to support the restoration of local spirometry services and is enhancing capacity through community diagnostic centres (CDCs). Spirometry tests are a minimum core test required of all standard or large CDCs. The Department does not currently hold validated data on the number of spirometry tests carried out in CDCs but, as part of guidance issued by NHS England in September 2024, CDCs are expected to perform a minimum of 80 spirometry tests a week if open five days a week, and 112 tests if open for seven days a week. The Elective Reform Plan, published on 6 January 2025, also sets out that we will extend the minimum standards for all CDCs to open 12 hours per day, seven days a week. As CDCs move to seven days, in line with expectations set out in the plan, they will increase overall activity in line with guidance.

What plans he has to increase the availability of spirometry testing in primary care.

NHS England is continuing to support the restoration of local spirometry services and is enhancing capacity through community diagnostic centres (CDCs). These initiatives provide structured pathways for general practitioners (GPs) to refer patients for essential respiratory diagnostic tests such as spirometry, ensuring faster access to these services for individuals with suspected respiratory conditions, including chronic obstructive pulmonary disease (COPD). By equipping primary care with the tools and pathways for earlier and more accurate diagnosis, this effort addresses the significant issue of undiagnosed COPD, which is estimated to affect 2.1 million people in England. These measures are designed to strengthen the collaboration between primary and secondary care, increasing capacity to meet diagnostic demands effectively.As part of Phase 2 of the GP Direct Access scheme, launched in December 2023, the National Health Service aims to achieve earlier detection and diagnosis of COPD so that patients access timely interventions and optimal treatment, improving patient management and outcomes. The guidance recommends that general practice teams refer patients for spirometry for the diagnosis of COPD.