Written questions by Platt.

Whether he plans to take steps to ensure a patients right of choice is not impacted by the proposed 2025-26 NHS payment scheme.

A patients’ right to choose is set out in legislation, and the proposed 2025/26 NHS Payment Scheme (NHSPS) makes no changes to this right. As required by the Health and Care Act 2022, NHS England has conducted an assessment of the impact of the proposed NHSPS. This is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/01/25-26-NHSPS-Consultation-notice-C-impact-assessment.pdf.This impact assessment includes consideration of the impact on patient choice, as well as an assessment of the impact on patients, in line with NHS England’s public sector equality duty.The Government is committed to patients having the right to choose their provider when referred to consultant-led treatment, or to a mental health professional, for their first appointment as an outpatient. Further information on the choices available for patients can be found on the NHS Choice Framework, which is available at the following link:https://www.gov.uk/government/publications/the-nhs-choice-framework

Whether he has made an assessment of the potential impact of the proposed 2025-26 NHS Payment Scheme on a patients right to choose.

A patients’ right to choose is set out in legislation, and the proposed 2025/26 NHS Payment Scheme (NHSPS) makes no changes to this right. As required by the Health and Care Act 2022, NHS England has conducted an assessment of the impact of the proposed NHSPS. This is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/01/25-26-NHSPS-Consultation-notice-C-impact-assessment.pdf.This impact assessment includes consideration of the impact on patient choice, as well as an assessment of the impact on patients, in line with NHS England’s public sector equality duty.The Government is committed to patients having the right to choose their provider when referred to consultant-led treatment, or to a mental health professional, for their first appointment as an outpatient. Further information on the choices available for patients can be found on the NHS Choice Framework, which is available at the following link:https://www.gov.uk/government/publications/the-nhs-choice-framework

What steps the Government is taking to financially support nursing homes with increases in National Insurance contributions.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The additional funding available to Wigan in 2025/26 means that they will see an increase to their core spending power of up to 9.0% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

What assessment his Department has made of the potential impact of increases to employers National Insurance contributions on (a) staff and (b) patients in private nursing homes.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The additional funding available to Wigan in 2025/26 means that they will see an increase to their core spending power of up to 9.0% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

What support his Department is providing to private nursing homes in (a) Leigh and Atherton constituency and (b) nationally, in the context of increases to employers National Insurance contributions.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The additional funding available to Wigan in 2025/26 means that they will see an increase to their core spending power of up to 9.0% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

Whether his Department has made an assessment of the potential impact of changes to employer National Insurance contributions on private nursing homes.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The additional funding available to Wigan in 2025/26 means that they will see an increase to their core spending power of up to 9.0% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

What steps he is taking to help armed forces veterans access mental health support in Leigh and Atherton constituency.

NHS England commissions Op COURAGE, the integrated mental health and wellbeing service, which allows veterans to make self-referrals. The Op COURAGE North service, run by the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, covers the Leigh and Atherton constituency area.The service, which is available across England, has been designed to support veterans from all areas, and is delivered from a range of locations, including National Health Service trusts, general practices (GPs), Poppy Shops, veteran hubs, and drop-in centres. Elements of the service may also be provided online if this is clinically appropriate. The Government recognises that not all veterans want to use veteran-specific mental health services and can instead choose to use mainstream National Health Services, such as talking therapies, which are available to both veterans and civilians.GPs are able to participate in the Veteran Friendly Practice Accreditation Scheme, which is a free support programme for GPs in England that enables GPs to easily identify, understand, and support veterans, and, where appropriate, refer them to specialist healthcare services designed especially for them, such as Op COURAGE. Over 99% of Primary Care Networks have at least one GP accredited as Veteran Friendly.

If he will make an assessment of the potential merits of establishing a centre of excellence for care and research for infection-associated chronic conditions.

We do not anticipate setting up a new centre of excellence for care and research specifically for post-viral or infection-associated conditions. The Department funds research on post-viral conditions through the National Institute for Health and Care Research (NIHR). The NIHR and Medical Research Council (MRC) remain committed to funding high-quality research to understand the causes, consequences, and treatment of post-viral conditions such as myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), and long COVID, and are actively exploring next steps for stimulating further research in this area. The MRC and NIHR currently fund research through a variety of routes, including infrastructure, research programmes, capacity building, for example research fellowships, and in the case of NIHR, research delivery to support recruitment to studies. Funding is available for infection-associated research.

Whether his Department has plans to allocate additional funding towards the Government's myalgic encephalomyelitis/chronic fatigue delivery plan.

There are currently no plans to allocate additional funding towards the myalgic encephalomyelitis / chronic fatigue (ME/CFS) final delivery plan. The ME/CFS final delivery plan continues to be developed.The plan will focus on improving research, attitudes and education, and bettering the lives of people with this disease. The consultation responses, alongside continued stakeholder engagement via the ME/CFS Task and Finish Group, will inform the development of the final delivery plan for ME/CFS, which we aim to publish by the end of March 2025.

What recent discussions he has had with (a) NHS England and (b) ITF Pharma UK on the provision of (i) resources and (ii) guidance to NHS trusts to enable them to take part in the Early Access Programme for givinostat.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, but the trusts must still cover the cost of administering it to patients. Only Duchenne muscular dystrophy clinicians can make requests for givinostat for their patients. Decisions are made on a case-by-case basis for individual named patients, aligned to eligibility criteria.NHS England does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

Whether his Department is taking steps to ensure that all eligible NHS Trusts participate in the early access programme for givinostat.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, but the trusts must still cover the cost of administering it to patients. Only Duchenne muscular dystrophy clinicians can make requests for givinostat for their patients. Decisions are made on a case-by-case basis for individual named patients, aligned to eligibility criteria.NHS England does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What steps his Department is taking to standardise the use of Pathological Demand Avoidance for autism diagnosis.

Pathological Demand Avoidance (PDA) is most often understood as a characteristic of, or observed in, some autistic people, but professional consensus on its status is still required. PDA is not a recognised and stand-alone diagnosis within the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Disease.It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including assessment services for autistic people, in line with National Institute for Health and Care Excellence (NICE) guidelines.The NICE guideline, Autism spectrum disorder in under 19s: recognition, referral and diagnosis, recommends that as part of autism assessments, healthcare workers should consider PDA, and carry out appropriate referrals.

What plans he has for the future of Long Covid clinics.

Commissioning of post-COVID-19 services is the responsibility of local integrated care boards.At a national level, NHS England is currently undertaking a stocktake, commissioned in September 2024 and due to complete at the end of this month, that will provide a more accurate, in-depth overview of the position of post-COVID-19 services throughout England.The stocktake will inform NHS England’s strategic recommendations, with clear responsibilities and accountability across the organisation, supporting matrix working to ensure these challenges are met with improvements.

Whether his Department is taking steps to regulate the advertising of vapes in local vape shops on high streets so that they do not appeal to children.

We know that vapes and other nicotine products are being deliberately branded and advertised to appeal to children. This must be stopped to protect future generations from being hooked on nicotine. The Tobacco and Vapes Bill has been introduced to Parliament, and bans vapes and nicotine products from being deliberately promoted and advertised to children to stop the next generation from becoming hooked on nicotine. The bill will ban all forms of advertising of vaping and other nicotine products, including in local vape shops, as well as sponsorship agreements which promote them.We must also reduce the visibility and accessibility of vapes to protect children and non-smokers from getting hooked on nicotine. The Tobacco and Vapes Bill will provide powers to introduce future regulations on where and how vapes and other nicotine products can be displayed, including in the windows and inside local vape shops.

What assessment he has made of the potential impact of the rise in employer National Insurance Contributions on (a) local carer support organisations and (b) their ability to provide support to unpaid carers in their area.

To enable local authorities to support key services such as adult social care, the Government will make 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.The Government is also committed to ensuring that families have the support that they need. To support unpaid carers, from April 2025 the Government will increase the Carer's Allowance weekly earnings limit from £151 a week to £196. This means carers can earn up to £10,000 a year whilst still retaining Carer's Allowance, which is approximately an additional £2,000 a year.

What steps he plans to take to implement the fresh approach to supporting unpaid carers recommended by the Darzi Review.

The Government is committed to ensuring that families have the support that they need. We want to ensure that people who care for family and friends are better able to look after their own health and wellbeing.We have already taken action to support unpaid carers. From April 2025 we will increase the Carer's Allowance weekly earnings limit from £151 a week to £196, the equivalent of 16 hours at the National Living Wage. This means carers can earn up to £10,000 a year whilst still retaining Carer's Allowance, which is approximately an additional £2,000 a year.Lord Darzi’s independent review of the National Health Service is clear that a fresh approach to supporting and involving unpaid carers is required to improve outcomes for carers, people needing care, and the NHS.We are carefully considering these findings as part of our 10-year plan for reforming and modernising the NHS, and as we develop plans to reform adult social care, including through the National Care Service.All unpaid carers can have their say on the future of the NHS to ensure their voice is heard by sharing their views at the following link:https://change.nhs.uk/en-GB/projects/start-here

What assessment he has made of the potential implications for his policies of local medical committees advising GPs to withdraw from ADHD shared care agreements; and what steps his Department plans to take to ensure there is uninterrupted access to essential medications and care for patients with ADHD.

Shared care arrangements between a specialist service and the patient’s general practice (GP) cover a number of clinical areas. Guidance is in place to help GPs decide whether to accept shared care responsibilities, with further information available at the following link: https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-care National Health Service clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing remains with the specialist clinician, and this applies to both NHS and private medical care. However, a GP who had previously agreed to, and had been deploying, a shared care agreement would need to demonstrate clear reasoning as to why they can no longer support this, and they have a responsibility, along with the specialist clinician, to secure continuity of care for their patient. Where possible, we encourage patients to raise any concerns directly with their GP in the first instance, as this is usually the fastest method of resolution, and can help to build a practice patient relationship. The Department has been working hard with industry and NHS England to help resolve the supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available. We are continuing to work to resolve the supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. To improve supply and resiliency, we are also working with prospective new suppliers of methylphenidate prolonged-release tablets to expand the UK supplier base.In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.

What steps his Department is taking to improve the provision of care for people with ME.

No assessment has been made on the adequacy of the implementation of National Institute for Health and Care Excellence (NICE) guidance NG206 on myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). NICE guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account in designing services to meet the needs of their local population, and to work towards their implementation over time.There are steps that the Government is taking to improve care for patients with ME/CFS. It is a priority for the Department to publish the final ME/CFS delivery plan. We cannot comment on the exact content of the final delivery plan at this time, but it will be shaped by the consultation responses, along with continued close engagement with stakeholders, with three broad themes of attitudes and education, research, and living with ME/CFS. We aim to publish it at the end of March 2025.The Department is also currently working with NHS England to develop an e-learning course on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes.Additionally, the Government funds research into ME/CFS through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), through UK Research and Innovation. In 2020, the NIHR and the MRC came together to fund the world’s largest genome-wide association study of ME/CFS. This £3.2 million study, termed DecodeME, will analyse samples from 25,000 people with ME/CFS to search for genetic differences that may indicate underlying causes or an increased risk of developing the condition. Further details of the study are available at the following link:www.decodeme.org.uk

What assessment his Department has made of the adequacy of implementation of NICE guideline NG206 on myalgic encephalomyelitis.

No assessment has been made on the adequacy of the implementation of National Institute for Health and Care Excellence (NICE) guidance NG206 on myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS). NICE guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account in designing services to meet the needs of their local population, and to work towards their implementation over time.There are steps that the Government is taking to improve care for patients with ME/CFS. It is a priority for the Department to publish the final ME/CFS delivery plan. We cannot comment on the exact content of the final delivery plan at this time, but it will be shaped by the consultation responses, along with continued close engagement with stakeholders, with three broad themes of attitudes and education, research, and living with ME/CFS. We aim to publish it at the end of March 2025.The Department is also currently working with NHS England to develop an e-learning course on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes.Additionally, the Government funds research into ME/CFS through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), through UK Research and Innovation. In 2020, the NIHR and the MRC came together to fund the world’s largest genome-wide association study of ME/CFS. This £3.2 million study, termed DecodeME, will analyse samples from 25,000 people with ME/CFS to search for genetic differences that may indicate underlying causes or an increased risk of developing the condition. Further details of the study are available at the following link:www.decodeme.org.uk

If he will have discussions with (a) the National Autistic Society and (b) other autism charities on (i) mental health reform and (ii) the detention of autistic people in mental health hospitals.

On 17 July 2024, the King’s Speech set out the Government’s commitment to modernise the Mental Health Act. Department officials are now working to prepare the Mental Health Bill for introduction when parliamentary time allows.As part of the Department’s preparations, plans are underway for stakeholder engagement once the bill is introduced. This will involve engaging with autism charities, including the National Autistic Society, on a range of related issues.