Written questions by Shannon.

Whether his Department plans to reform colonoscopy services.

A table showing the number of people on a waiting list for a colonoscopy each year between 2020 and 2024, broken down by acute National Health Service trust, is attached. Monthly activity and waiting list data for diagnostics is published monthly, and is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/Validated data collections on the breakdown of insourced and outsourced activity by NHS trusts, including for individual procedures such as a colonoscopy, are not maintained at a national level, so we do not hold information on how much was spent to outsource or insource additional resources to manage colonoscopy procedures in each of the last five years, by trust.The Government is committed to transforming diagnostic services, including for colonoscopies, and will support the NHS to increase capacity to meet the demand for these services.The NHS is delivering on a number of specific steps to reduce waiting times for gastrointestinal (GI) endoscopy services, including colonoscopy procedures. This includes the establishment of a national transformation project to recover GI endoscopy services, investment in an additional 80 dedicated endoscopy rooms to expand capacity, as well as a number of Community Diagnostic Centres offering endoscopy services.NHS England has also established GI endoscopy networks across the country. Whilst many are still in their infancy, one of the key functions of these networks is to address unwarranted variation in timely access to care. GI endoscopy training academies have also been established in each region to enable the training and education of the required workforce.At the 2024 Autumn Budget, my Rt Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community.

How many people were on waiting lists for colonoscopies in each year between 2020 and 2024 by trust.

A table showing the number of people on a waiting list for a colonoscopy each year between 2020 and 2024, broken down by acute National Health Service trust, is attached. Monthly activity and waiting list data for diagnostics is published monthly, and is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/Validated data collections on the breakdown of insourced and outsourced activity by NHS trusts, including for individual procedures such as a colonoscopy, are not maintained at a national level, so we do not hold information on how much was spent to outsource or insource additional resources to manage colonoscopy procedures in each of the last five years, by trust.The Government is committed to transforming diagnostic services, including for colonoscopies, and will support the NHS to increase capacity to meet the demand for these services.The NHS is delivering on a number of specific steps to reduce waiting times for gastrointestinal (GI) endoscopy services, including colonoscopy procedures. This includes the establishment of a national transformation project to recover GI endoscopy services, investment in an additional 80 dedicated endoscopy rooms to expand capacity, as well as a number of Community Diagnostic Centres offering endoscopy services.NHS England has also established GI endoscopy networks across the country. Whilst many are still in their infancy, one of the key functions of these networks is to address unwarranted variation in timely access to care. GI endoscopy training academies have also been established in each region to enable the training and education of the required workforce.At the 2024 Autumn Budget, my Rt Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community.

What discussions he has had with his Northern Irish counterpart on funding for hospices.

Healthcare, including hospice care, in Northern Ireland is devolved, and therefore a matter for the Northern Ireland Executive, although we are always happy to learn from the experiences of devolved governments.

How much was spent to (a) outsource and (b) insource additional resource to manage colonoscopy procedures in each of the last five years by trust.

A table showing the number of people on a waiting list for a colonoscopy each year between 2020 and 2024, broken down by acute National Health Service trust, is attached. Monthly activity and waiting list data for diagnostics is published monthly, and is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/Validated data collections on the breakdown of insourced and outsourced activity by NHS trusts, including for individual procedures such as a colonoscopy, are not maintained at a national level, so we do not hold information on how much was spent to outsource or insource additional resources to manage colonoscopy procedures in each of the last five years, by trust.The Government is committed to transforming diagnostic services, including for colonoscopies, and will support the NHS to increase capacity to meet the demand for these services.The NHS is delivering on a number of specific steps to reduce waiting times for gastrointestinal (GI) endoscopy services, including colonoscopy procedures. This includes the establishment of a national transformation project to recover GI endoscopy services, investment in an additional 80 dedicated endoscopy rooms to expand capacity, as well as a number of Community Diagnostic Centres offering endoscopy services.NHS England has also established GI endoscopy networks across the country. Whilst many are still in their infancy, one of the key functions of these networks is to address unwarranted variation in timely access to care. GI endoscopy training academies have also been established in each region to enable the training and education of the required workforce.At the 2024 Autumn Budget, my Rt Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community.

What assessment he has made of the potential implications for his policies of the average time from women finding breast lumps to being referred for diagnostic tests.

People presenting to their general practice (GP) with signs or symptoms that could indicate breast cancer may be referred on the suspected breast cancer referral pathway, or the breast symptoms referral pathway, depending on the details of their case. Suspected breast cancer contributes the highest number of referrals of any urgent suspected cancer pathway, with over 376,000 patients seen in 2023/24.The National Health Service in England committed, in the NHS Long Term Plan, to provide faster diagnosis through the introduction of the Faster Diagnosis Standard (FDS). The standard ensures that people are told they have cancer, or that cancer is ruled out, within 28 days from referral. This applies to the suspected breast cancer pathway and the breast symptoms pathway. Further information on the NHS Long Term Plan is available at the following link:https://www.longtermplan.nhs.uk/In March 2024, NHS England published the Breast Best Practice Timed Pathway Guidance to support the ongoing improvement effort to shorten diagnosis pathways, reduce variation, improve experience of care, and meet the FDS. The most recent data, for August 2024, shows that 90.4% of patients with suspected breast cancer receive a diagnosis or all-clear within 28 days of referral.The Department does not hold data on the average time from women finding breast lumps to being referred for diagnostic tests. However, data from the 2023 Cancer Patient Experience Survey indicates that the majority of respondents diagnosed with breast cancer had spoken to a health professional at their GP about their symptoms only once before being diagnosed.

How many long covid clinics are active.

Since 2020, the National Health Service in England has invested significantly in supporting people with long COVID. This includes setting up specialist post-COVID services nationwide for adults, and children and young people, as well as investing in ensuring general practice (GP) teams are equipped to support people affected by the condition.As of 1 April 2024, there are over 90 adult post-COVID services across England, along with an additional ten children and young people’s hubs. These services assess people with long COVID and direct them into care pathways which provide appropriate support and treatment. GPs will assess patients that have COVID-19 symptoms lasting longer than four weeks and refer them into a long COVID service where appropriate. Referral should be via a single point of access, which is managed by clinician-led triage.

What estimate he has made of the number of children who have been fully vaccinated for MMR in the last year.

Official childhood vaccine coverage estimates, including for the measles, mumps, and rubella (MMR) vaccine, are published annually by the UK Health Security Agency (UKHSA) and NHS England, and also quarterly by UKHSA. Coverage of childhood vaccines are measured when children reach their first, second, and fifth birthdays.Annually published coverage figures from the Cover of Vaccination Evaluated Rapidly surveillance scheme show that for 2023/24, at two years old, 649,287 out of 726,395 children, or 89.4%, have one dose of MMR coverage. At five years old, 721,672 out of 781,492 children, or 92.3%, have one dose of MMR coverage, and 660,680 out of 781,492 children, or 84.5%, have two doses.

What progress his Department has made on providing universal access to fracture liaison services by 2030.

The Government and NHS England support the clinical case for services which help to prevent fragility fractures and to support patients who sustain them. Fracture Liaison Services are a globally recognised care model and can reduce the risk of refracture for people at risk of osteoporosis by up to 40%, depending on the fracture type and population considered.That is why expansion of Fracture Liaison Services is a key priority for the Department and officials are working closely with NHS England to consider a range of options exploring the most effective ways to ensure access to these important preventative services across the country.

How many people aged between 16 and 25 are medically treated for psoriasis in England, broken down by (a) age and (b) gender.

A table showing a count of Finished Admission Episodes (FAEs) for patients aged 16 to 25 years old with a recorded primary diagnosis of psoriasis, broken down by patient age and gender, for the period 2019/20 to 2023/24, and in English National Health Service hospitals, is attached.Please be aware that the majority of psoriasis is treated by a general practitioner or elsewhere in the community, with only a small minority of cases, typically the most serious, requiring hospital admission. The data presented will, therefore, only represent a small proportion of the total number of cases that were treated.

What assessment he has made of the potential implications for his policies of the exposure of babies to microplastics.

While there are National Health Service trusts involved in research on the effects of microplastics on certain health issues, the Department has made no assessment of the potential implications for policies of the exposure of babies to microplastics.

What assessment he has made of the adequacy of funding for hospices in the last three years.

Most hospices are charitable, independent organisations which receive some statutory funding from the National Health Service. The amount of funding each charitable hospice receives varies both within and between integrated care board (ICB) areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.

If he will make an assessment of the potential impact of local authority charges for social care services on vulnerable unpaid carers.

Adult social care charging policy is designed to ensure that people who are drawing on care are only charged what they can afford for their care and support. Under the Care Act 2014, local authorities are required to deliver a wide range of sustainable, high-quality care and support services, including support for carers. This includes undertaking a carer’s assessment to support people caring for family or friends, and to meet their eligible needs when requested.

What steps he is taking to reduce waiting lists for cardiac treatments.

Tackling waiting lists is a key part of our Health Mission. The waiting list for England at the end of August stood at 7.64 million patient pathways, with 418,669 waiting for treatment for cardiology.We will deliver an extra 40,000 operations, scans, and appointments per week, including in cardiology services, as a first step in our commitment to ensuring patients can expect to be treated within 18 weeks, supported by new funding announced at the Autumn Budget. We will be supporting National Health Service trusts to deliver these through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.The Government is committed to putting patients first. This means making sure that patients across all specialities, including cardiology, are seen on time, and ensuring that people have the best possible experience during their care. We know that waiting lists are a challenge across the United Kingdom and the Government is keen to take a collaborative approach so that there is strong recovery across all four nations.

What steps he is taking to raise awareness of stroke symptoms among young people.

Although stroke is rare in children and young people, education around the early signs of a stroke in adults, like those shown in the Act FAST Campaign, is still relevant. Spotting the early signs assists in rapid diagnosis, access to time-dependent acute stroke care, and delivery of community-based stroke rehabilitation. Further information about the Act FAST campaign is available at the following link:https://www.england.nhs.uk/actfast/NHS England works collaboratively with The Stroke Association and Different Strokes, who focus on helping younger stroke survivors to share key messaging. Further information is available at The Stroke Association and Different Strokes’ websites, which are available, respectively, at the following two links:https://www.stroke.org.uk/https://differentstrokes.co.uk/Evidence based clinical guidelines on stroke in childhood have been published by the Royal College of Paediatrics and Child Health and the Stroke Association, and are accredited by the National Institute for Health and Care Excellence. These include recommendations for diagnosis, management, and rehabilitation. These guidelines are available at the following link:https://www.rcpch.ac.uk/sites/default/files/2021-02/Stroke%20guideline%2008.04.19%20updated%202021.pdf

What steps he is taking to ensure that men at risk of prostate cancer are able to access prostate specific antigen tests.

Currently men who have symptoms that could be associated with prostate cancer may be offered a test called the Prostate Specific Antigen (PSA) test, which looks at levels of PSA in the blood in line with National Institute for Health and Care Excellence cancer recognition and referral guidance. However, due to the poor ability of PSA to predict cancer, the PSA test is not recommended as a screening tool for healthy men with no symptoms. This includes those at higher risk of prostate cancer.This is because the high level of inaccuracy could lead to unnecessary tests that carry risks of life-changing harm, such as urinary and faecal incontinence, sexual dysfunction, as well as a smaller but serious risk of sepsis. Additionally, some prostate cancers may not produce elevated PSA levels, leading to false-negative results that provide deceptive reassurance.Instead, men should be encouraged to know the symptoms of prostate cancer and look out for changes in their body and seek advice from a general practitioner if these changes occur.

What discussions he has had with the Health Minister in Northern Ireland on delays in occupational therapy referrals.

Whilst my Rt. Hon. friend, the Secretary of State for Health and Social Care has met with his counterpart in Northern Ireland to discuss various issues related to health, occupational therapy was not discussed. Health is a devolved matter for Northern Ireland.

What steps he is taking with the Secretary of State for Education to ensure adequate mental health provision in schools for young people with eating disorders.

The Department is working across the Government to consider how to deliver our commitment of a specialist mental health professional in every school. Alongside this we are working toward rolling out Young Futures hubs in every community and working with colleagues at the Department for Education and NHS England to consider options to deliver our commitment to recruit 8,500 additional mental health workers across both adult, and children and young people’s mental health services.It will be important that these commitments can provide appropriate support for children and young people with a range of mental health needs, including eating disorders.

What steps he is taking to help prevent cases of Oropouche virus; and what discussions he has had with devolved Administrations on that virus.

The UK Health Security Agency (UKHSA) continuously monitors the global epidemiology of the Oropouche virus disease, and assesses risk to the United Kingdom’s population. The UKHSA works to reduce risk through the provision of travel advice to both travellers and healthcare professionals, including through the National Travel Health Network and Centre and through awareness raising through media engagement, when appropriate.The UKHSA has undertaken specific work to raise the awareness of the Oropouche virus disease among healthcare professionals, including targeted communication and discussion with professional obstetrics and gynaecology networks. UKHSA subject matter experts have contributed to publications in scientific and medical journals to raise clinician awareness. The UKHSA has also provided expert commentary to media outlets, to ensure that accurate travel health advice is included in media articles.Molecular testing for acute Oropouche virus disease is available in the UK through the UKHSA’s Rare and Imported Pathogens Laboratory (RIPL), in Porton Down. Following the increase in cases in the Americas in 2024, the RIPL has also been performing active surveillance through testing samples submitted for dengue diagnosis, where the patient has travelled to a region affected by the Oropouche virus disease and subsequently tests negative for dengue. No imported cases have been detected in the UK to date. Epidemiological alerts published by the Pan American Health Organisation and World Health Organisation have been shared with the devolved administration’s public health organisations

What steps he is taking to help reduce delays in treatment for cancer patients.

Lord Darzi’s report has set out the scale of the challenges we face in fixing the National Health Service and the need to improve cancer waiting time performance and cancer survival. In particular, he highlighted the need to improve the number of patients starting their treatment within 62 days of referral and to increase the number of patients diagnosed at an earlier stage.We will improve cancer survival rates and hit all NHS cancer waiting time targets within five years, so no patient waits longer than they should.The NHS will maximise the pace of the roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.

If he will make an assessment of the adequacy of guidance issued by his Department on the best time to take blood pressure medication.

The National Health Service monitors evidence on all interventions and updates our public facing guidance accordingly. The routine review of blood pressure medication guidance on the NHS website is due in December 2024. However, the timing of medication is a clinical decision which is made by doctors, and depends on several patient factors.