Written questions by Platt.

What steps his Department is taking to supporting people with Long Covid in the context of the closure of Long Covid clinics.

Across the National Health Service in England there are services supporting people with post-COVID syndrome, also known as long COVID. These services offer physical, cognitive, and psychological assessment, and, where appropriate, refer patients onto existing services for treatment and rehabilitation. Further information can be found on NHS England’s website, at the following link:https://www.england.nhs.uk/coronavirus/post-covid-syndrome-long-covid/The commissioning of post-COVID services transitioned from the long COVID national programme to local integrated care boards (ICBs) at the end of March 2024. Funding for post-COVID services in 2024/25 was expected to be allocated based on the previous distribution for 2023/24, to minimise disruption to funding flows and maintain services.NHS England has published commissioning guidance for post-COVID services which sets out the commissioning and service requirements and the oversight of post-COVID services by the ICBs in England for adults, and children and young people (CYP). It outlines the elements that post-COVID services should comprise of and the principles of care for long COVID, and is available at the following link:https://www.england.nhs.uk/long-read/commissioning-guidance-for-post-covid-services-for-adults-children-and-young-people/There is specific advice for general practitioners to manage long COVID. Patients should be managed according to current clinical guidance, such as that published and updated by the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners, which is available at the following link:https://www.nice.org.uk/guidance/NG188Primary care plays a key role in the long COVID clinical pathway, in considering and excluding potential other causes of symptoms and in determining the appropriate management of symptoms and the timing of onward referral to post-COVID services, if appropriate. A post-COVID-19 syndrome diagnostic pathway, the criteria for referral to post-COVID services, and separate adult and CYP pathways are outlined in the commissioning guidance to help provide consistency of delivery and to improve patient experience.Not all people who report long COVID symptoms will require assessment in a post-COVID assessment service. For example, some of the most common symptoms may still not warrant a specialist assessment as people can benefit from self-management advice, including from the NHS website. Some people may be seen in other disease-specific pathways, depending on their individual circumstances.NHS England has recently completed a long COVID and myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), stocktake, which aimed to provide a nationwide overview of service delivery in commissioning and contracting, assessing access, activity, and outcomes. The findings confirmed widely recognised challenges, specifically significant variation in care delivery across England, and a lack of comprehensive activity data.Executive NHS England board members were updated on the current provision of long COVID and ME/CFS services, noting those challenges. Discussions considered service prioritisation and potential COVID Inquiry recommendations. It was agreed that long COVID and ME/CFS services are rightly commissioned by ICBs, which have responsibility for ensuring coverage for their population.Furthermore, to support clinical leadership in this area, NHS England has worked in partnership with the British Society of Physical and Rehabilitation Medicine to develop a new Clinical Post-COVID Society to facilitate the ongoing sharing of best practice, to support people affected by long COVID. Further information about the society is available at the following link:https://www.clinicalpcs.org.uk

Pursuant to the Answer of 30 January 2025 to Question 26770 on Chronic Fatigue Syndrome: Health Services, whether the results from the NHS England stocktake will be published.

NHS England’s long COVID and myalgic encephalomyelitis, also known as chronic fatigue syndrome, stocktake aimed to collate information about service commissioning, activity, and delivery, to provide a national overview of the services commissioned by integrated care boards as part of their core activity. The stocktake was completed for an internal NHS England committee and, therefore, there are no plans to publish the findings. However, those findings did confirm the widely recognised challenges of significant variation in care delivery across England, and a lack of comprehensive activity data.

What assessment he has made of the potential impact of the proposed 2025/26 NHS Payment Scheme consultation to enable Integrated Care Boards (ICBs) to set financial limits for each independent provider delivering services under patient right of choice regulations where the level of activity is greater than £0.1 million per year on ADHD waiting times.

A patients’ right to choose is set out in legislation. 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.pdfThis 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.Local integrated care boards (ICBs) are responsible for planning service provision in their local area, including for attention deficit hyperactivity disorder assessments. In doing so, ICBs should take account of waiting lists, and should consider how local funding can be deployed to best meet the needs of their local population.

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

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 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.

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 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.

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.

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 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 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/

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 unp

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 G...

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 unpai...

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

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 t...