Written questions by Robertson.

What steps he is taking to ensure that funding allocated to the NHS in the Autumn Budget 2024 is being used to (a) boost productivity and (b) reduce waiting times.

My Rt. Hon. Friend, the Chancellor of the Exchequer allocated an additional £25.7 billion to the National Health Service at the Autumn Statement over this year and the next, which includes over £2 billion for technological and digital transformation to improve productivity, and £1.8 billion to support elective recovery and activity to reduce waiting times.The investment in technology includes the continued expansion of the use of Electronic Patient Records across all NHS trusts to improve care coordination and streamline patient management, and the continued development of the NHS App to enable better patient access to services and information. Combined with a range of other actions, including spreading clinical and operational best practice and reducing temporary staffing, we have committed to delivering a 2% growth in productivity in 2025/26.The £1.8 billion investment will directly support elective recovery and activity in 2024/25. This funding will help the NHS to deliver two million additional operations, scans, and appointments in our first year in Government, the equivalent to 40,000 per week, as a first step towards ensuring that patients can expect to be treated within 18 weeks.Elective funding beyond 2024/25 is being considered and will be announced within the upcoming Spending Review.

What steps his Department is taking to help reduce the number of rogue operators who do not observe visa employment rules in the social care sector.

We have seen unacceptable increases in unethical practices and exploitation of international recruits in the adult social care sector. The Code of Practice for International Recruitment sets out high ethical standards and best practice for recruiters and employers to follow to ensure people coming from overseas are treated fairly and provided with the appropriate support.The Department works closely with regulators, local authorities, other departments, and enforcement bodies to share concerns and intelligence about illegal or unethical practices in adult social care. The Gangmasters and Labour Abuse Authority investigates reports of worker exploitation and illegal activity, such as human trafficking, modern slavery, forced labour, and other labour market offences. The Government is also delivering the legislation for a new flagship Fair Work Agency, ensuring fair and strong employment rights for all.The Home Office has also begun delivery of new measures meaning that any business found guilty of serious employment law breaches, such as failing to comply with National Minimum Wage, will have action taken against them – up to and including having their visa sponsorship licences refused or revoked. The changes will also prohibit sponsors of Skilled Workers from the unethical practice of charging or recovering costs from workers for the cost of sponsoring them.In addition, the Department of Health and Social Care has provided £16 million to regional partnerships this financial year to support them to prevent and respond to unethical practices. This includes support for international recruits to understand their rights and establishing operational processes with regional partnerships to support individuals to switch employers and remain working in the care sector when they have been impacted by their sponsor’s licence being revoked.

Pursuant to the Answer of 10 February 2025 to Question 27757 on Department of Health and Social Care: Public Relations, what the purpose of the contract with Mullen Lowe was; which programmes were funded; whether there were key performance indicators; and if he will place a redacted copy of the contract in the House of Commons Library.

Mullen Lowe holds a contract with the Department for a range of marketing services to support the delivery of campaigns. This includes advertising, creative and production, digital partnerships, and public relations services, among others. In the current financial year, this has included delivery of smoking cessation, adult social care recruitment, vaccinations, and early years campaigns.Service level agreements and performance monitoring arrangements are detailed in the contract in pages 82 to 87. Regular performance review meetings are held with Mullen Lowe. A redacted version of the contract is stored on the publicly available contract finder and is available at the following link:https://www.contractsfinder.service.gov.uk/notice/3a9662e5-85bd-40b9-83fb-e5a6615d7a05?origin=SearchResults&p=1

Pursuant to the Answer of 7 February 2025 to Question 25535 on Viral Diseases, if he will make an assessment of the potential impact of means-testing the winter fuel payment on the number of cases of (a) flu, (b) covid-19, (c) norovirus and (d) respiratory syncytial virus.

The Department has no current plans to undertake an assessment of the potential impact of means-testing the winter fuel payment on the number of flu, COVID-19, norovirus and respiratory syncytial virus cases.The relationship between cold weather and respiratory illness in general, such as exacerbation of chronic bronchitis, is well established in scientific evidence. However, a link from cold snaps, or housing temperature, to respiratory infections does not have the same evidential base.Further information is available at the following link:https://www.gov.uk/government/statistics/surveillance-of-influenza-and-other-seasonal-respiratory-viruses-in-the-uk-winter-2023-to-2024/surveillance-of-influenza-and-other-seasonal-respiratory-viruses-in-the-uk-winter-2023-to-2024

What steps his Department is taking to end exploitative employment practices by social care employers.

We have seen unacceptable increases in unethical practices and exploitation in the adult social care sector. The Department works closely with regulators, local authorities, other departments, and enforcement bodies to share concerns and intelligence about unethical practices in adult social care. The Gangmasters and Labour Abuse Authority investigates reports of worker exploitation and illegal activity, such as human trafficking, modern slavery, forced labour, and other labour market offences. The Government is also delivering the legislation for a new flagship Fair Work Agency, ensuring fair and strong employment rights for all.In relation to the exploitation of international recruits, £16 million has been provided to regional partnerships this financial year to support them to prevent and respond to unethical practices. The Home Office has also recently announced measures to ban rogue employers from sponsoring overseas workers.

What assessment he has made of the potential merits of publishing year-round data on the number of patients being treated in temporary care environments.

The Government is clear that patients should expect and receive the highest standard of service, and is determined to tackle the issue of corridor care.On 30 January, we published Road to recovery: the government's 2025 mandate to NHS England, which set out the priorities and actions to be taken to reform and improve urgent and emergency care services.We continue to keep the data available and published to support improvements to urgent and emergency care services under review. Subject to data quality, NHS England would intend to publish data collected on the use of temporary escalation spaces in the spring.

What steps his Department is taking to end the use of corridor care in the NHS.

The Government is clear that patients should expect and receive the highest standard of service, and is determined to tackle the issue of corridor care.On 30 January, we published Road to recovery: the government's 2025 mandate to NHS England, which set out the priorities and actions to be taken to reform and improve urgent and emergency care services.We continue to keep the data available and published to support improvements to urgent and emergency care services under review. Subject to data quality, NHS England would intend to publish data collected on the use of temporary escalation spaces in the spring.

What assessment his Department has made of the potential implications for its policies of exploitative employment practices by social care employers.

We have seen unacceptable increases in unethical practices and exploitation in the adult social care sector. The Department works closely with regulators, local authorities, other departments, and enforcement bodies to share concerns and intelligence about unethical practices in adult social care. The Gangmasters and Labour Abuse Authority investigates reports of worker exploitation and illegal activity, such as human trafficking, modern slavery, forced labour, and other labour market offences. The Government is also delivering the legislation for a new flagship Fair Work Agency, ensuring fair and strong employment rights for all.In relation to the exploitation of international recruits, £16 million has been provided to regional partnerships this financial year to support them to prevent and respond to unethical practices. The Home Office has also recently announced measures to ban rogue employers from sponsoring overseas workers.

What steps he is taking to improve digital (a) literacy and (b) confidence in NHS clinical staff.

We are striving for digital services to improve access, experiences, and outcomes for the widest range of people, based on their preferences, as any digital healthcare benefits will be limited if people remain digitally excluded.Mitigating against the risk of digital exclusion is one of five key priorities that NHS England has asked the integrated care systems to address in their drive to reduce healthcare inequalities. NHS England successfully ran a number of programmes to support patients, carers, and health service staff with their digital literacy. These include: the NHS App Spoken Word Pilot project, designed to test the efficacy of promoting National Health Service digital health products and services in languages other than English;the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online; andthe Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation, and means to access health information and services online. NHS England has also published a framework for NHS action on digital inclusion and is developing further resources to support practical actions and to build clinical confidence in using digital tools. All digital programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion.

What steps his Department is taking to ensure that patients with dementia living in (a) rural and (b) socio economically-deprived areas are diagnosed as quickly as those in other areas.

Given the level of inequalities known within dementia diagnosis, NHS England commissioned the Office for Health Improvement and Disparities (OHID) to develop a resource to support investigation of the underlying variation in dementia diagnosis rates.The OHID’s Dementia Intelligence Network developed a tool for local systems, which includes an assessment of population characteristics such as rurality and socio-economic deprivation. This enables systems to investigate local variation in diagnosis and take informed action to enhance their diagnosis rates.The tool has been released and is available via the NHS Futures Collaboration platform.

What steps he is taking to integrate digital tools into NHS services to help (a) tailor those services to the diverse needs of patients and (b) improve those services.

Patients are able to access National Health Services, such as requesting general practice appointments and managing secondary care appointments, through local online tools and the NHS App, which can also be accessed through a web browser. The NHS App is designed to meet international accessibility standards, and the services are routinely tested with a range of people with accessibility issues. However, digital health tools are part of a wider offering that includes face-to-face support, with appropriate help for people who struggle to access digital services. NHS England has also published a framework for NHS action on digital inclusion, and is developing further resources to support practical actions. All digital programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion.

If he will make an assessment of the effectiveness of community pharmacies in maintaining public health.

Pharmacies are commissioned to deliver a range of evidence-based services that contribute to public health, including providing advice on maintaining health, treatment for common conditions, identifying people with high blood pressure, initiating and managing oral contraception, and providing vaccination services.National Health Service pharmaceutical services delivered in community pharmacy are also subject to evaluations to assess outcomes such as clinical appropriateness, and impacts on patients and other parts of the NHS. This includes the National Institute for Health and Care Research’s evaluation of Pharmacy First to assess how the service has been implemented across England, including impacts on prescribing in the general practice setting, use of hospitals, and how the service has impacted access to care and costs for different patient groups.

What steps he is taking with NHS England to tackle diagnostic overshadowing of dementia symptoms for patients with learning disabilities.

The annual health check for people with learning disabilities should include a review of mental health, including signs of dementia, especially in adults with Down’s syndrome. People requiring an assessment for dementia should be referred to a clinician with specialist expertise in the mental health of people with learning disabilities. Assessment for dementia should be supplemented with tools devised for use with people with learning disabilities. Under the Health and Care Act 2022, from 1 July 2022 Care Quality Commission registered providers are required to ensure that their staff receives specific training on learning disability and autism, appropriate to their role. This will help to ensure that staff have the right knowledge and skills to provide safe and informed care.To support providers to meet the statutory training requirement, we have been rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce. This training includes content on avoiding diagnostic overshadowing and frequently co-occurring conditions. Over two million people have completed the e-learning package, which is the first part of this training, and over 1,700 trainers are delivering the interactive second part of this training across the country.The Department funds dementia research through the National Institute for Health and Care Research (NIHR), which includes research with people with learning disabilities. For example, the NIHR is funding a study testing the neuroimaging method of functional near infrared spectroscopy to detect cognitive decline in people with Down’s syndrome.

If his Department will take steps to increase the (a) number of specialists in and (b) level of training on young onset dementia in memory assessment services.

We recognise that those with young onset dementia who draw on care and support have different ambitions and face different challenges to older age adults.The Government is committed to transforming diagnostic services, including the detection and diagnosis of dementia, and will support the National Health Service to increase capacity to meet the demand for diagnostic services.Under Care Quality Commission Regulation 18: Staffing, persons employed by the service provider in the provision of a regulated activity must receive such appropriate support, training, professional development, supervision, and appraisal as is necessary to enable them to carry out the duties they are employed to perform. This would include receiving appropriate support to carry out duties linked to young onset dementia.The required training needs are set out in the Dementia Training Standards Framework, commissioned and funded by the Department and developed in collaboration with the sector, which is available at the following link:https://www.skillsforhealth.org.uk/info-hub/dementia-2015-updated-2018/

What steps his Department is taking to help reduce the backlog of people waiting for elective mental health care.

Patients have been let down for too long whilst they wait for the care they need. Currently, the elective waiting list stands at 7.48 million patient pathways, with over six million people waiting. We are committed to putting patients first, making sure that patients are seen on time, and ensuring that people have the best possible experience during their care.As set out in the Government’s Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from Referral to Treatment by March 2029, a standard which has not been met consistently since September 2015. This includes those patients waiting for mental health services where the referral is made to a medical consultant-led mental health service.The majority of National Health Service mental health care is outside the scope of the elective waiting list and the referral to treatment 18-week constitutional standard. With regard to mental health care more broadly, we know that too many people with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure that mental health is given the same attention and focus as physical health, so that people can be confident in accessing high quality mental health support when they need it. We will recruit an additional 8,500 mental health workers to reduce delays and provide faster treatment which will also help ease pressure on hospitals. We will also ensure every young person has access to a mental health professional at school, and will set up Young Futures hubs in every community, offering open access mental health services for young people.

What steps his Department is taking to help stabilise primary care.

The 10-Year Health Plan will describe a shared vision for the health and care system in 2035, drawing directly from the extensive engagement underway with the public, patients, and staff.We have announced a proposed £889 million uplift for general practice (GP) in 2025/26 and set out the proposed areas of reform which will help us to deliver on our commitments. This is the largest uplift to GP funding since the beginning of the five-year framework and means we are reversing the recent trend with a rising share of total National Health Service resources going to GPs.By fixing the front door of our health service we will ensure everyone can access GP services. We will make sure the future of GPs is sustainable by training thousands more GPs, guaranteeing a face-to-face appointment for all those who want one, and delivering a modern booking system. We have already started hiring an extra 1,000 GPs into the NHS and uplifted a monthly payment to practices by 7.4%.We want to take pressure off GPs, by improving access to community pharmacies and creating a Community Pharmacist Prescribing Service. We are currently in consultation with Community Pharmacy England regarding the funding arrangements for 2024/25 and 2025/26 and are unable to say more until this consultation is completed.The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.

What steps his Department is taking to ensure (a) timely and (b) equitable dementia diagnosis.

The Government and NHS England remain committed to increasing the dementia diagnosis rate to the national ambition of 66.7%. To support recovery of the dementia diagnosis rates and implementation of the Dementia Care Pathway, NHS England has developed a dashboard for management information purposes. The aim is to support commissioners and providers of memory services with appropriate data and enable targeted support where needed.NHS England has also funded an evidence-based improvement project to fund two trusts in each region, 14 sites in total, to pilot the Diagnosing Advanced Dementia Mandate tool to improve the diagnosis of dementia and the provision of support in care homes. All pilots completed at the end of May 2024, and it is anticipated that learning will be shared in early 2025.The Department delivers dementia research through the National Institute for Health and Care Research (NIHR). The NIHR funds a range of research into dementia, for example an £11 million programme to develop new digital approaches for the early detection and diagnosis of dementia. The NIHR is also partnering with the Economic and Social Research Council and Alzheimer’s Society to support a £5.5 million investment in four Dementia Network Plus research grants. One of the networks, EQUADEM, seeks to address inequalities in dementia diagnosis and care.The Government’s Dame Barbara Windsor Dementia Goals programme is investing in biomarker innovations, ranging from an artificial intelligence tool designed to improve the accuracy of blood tests for dementia, to using retinal scans to detect early-onset dementia decades before symptoms. Some of these innovations could support improved diagnosis in the future, if validated for clinical use.To reduce variation in diagnosis rates, the Office for Health Improvement and Disparities’ Dementia Intelligence Network has developed a tool for local systems, which includes an assessment of population characteristics, such as rurality and socio-economic deprivation. This enables systems to investigate local variation in diagnosis and take informed action to enhance their diagnosis rates. The tool has been released and is available via the NHS Futures Collaboration platform.

What steps he is taking to (a) invest in diagnostic infrastructure and (b) reduce waiting times.

The Darzi Report highlights the significant underinvestment of capital in the National Health Service, with outdated scanners, too little automation, and a failure to enter the digital era. Patients have been let down for too long whilst they wait for the care they need, including diagnostic testing, which is key to the majority of elective and cancer pathways.Currently, the elective waiting list stands at 7.48 million patient pathways, with over six million people waiting. The Elective Reform Plan, published in January 2025, sets out the reforms needed to return to the 18-week Referral to Treatment (RTT) constitutional standard by March 2029, a standard which has not been met consistently since September 2015. This will include ensuring the diagnostic capacity needed to deliver on the standard.The Elective Reform Plan commits to transforming and expanding diagnostic services and speeding up waiting times for tests, a crucial part of reducing overall waiting times and returning to the RTT standard. This includes investment in Community Diagnostic Centres (CDCs), expanding the number of CDCs operating seven days a week and 12 hours a day, as well as the tests they offer. We will also develop and roll out Straight to Test pathways, reducing the time taken for patients to receive a test, as well further improvements to the NHS’ digital capabilities. An investment of approximately £1.5 billion, as announced in the Autumn Budget, will enable diagnostics services to build on these foundations in 2025/26, to ensure diagnostic services are fit for the future. This will ensure that patients receive the diagnostic care where and when they need it, including for subtype diagnoses.

Whether his Department plans to implement a commission lead review on dementia diagnostics.

Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.The 10-Year Health Plan will address the challenges diagnosed by Lord Darzi, and set the vision for what good joined-up care looks like for people with a combination of complex health and care needs. It will set out how we support and enable health and social care services to work together better to provide that joined-up care.The Government is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission, which is expected to begin in April 2025, will form a key part of the Government’s Plan for Change, recognising the importance of adult social care in its own right, as well as its role in supporting the National Health Service.It is a once in a generation opportunity to transcend party politics and engage in genuine debate on how we can deliver a National Care Service, ensuring all voices are heard, and putting the voices of those with lived experience at the heart of the conversation.

What steps his Department is taking to (a) future proof diagnostic systems and (b) improve access to subtype diagnoses in systems.

The Darzi Report highlights the significant underinvestment of capital in the National Health Service, with outdated scanners, too little automation, and a failure to enter the digital era. Patients have been let down for too long whilst they wait for the care they need, including diagnostic testing, which is key to the majority of elective and cancer pathways.Currently, the elective waiting list stands at 7.48 million patient pathways, with over six million people waiting. The Elective Reform Plan, published in January 2025, sets out the reforms needed to return to the 18-week Referral to Treatment (RTT) constitutional standard by March 2029, a standard which has not been met consistently since September 2015. This will include ensuring the diagnostic capacity needed to deliver on the standard.The Elective Reform Plan commits to transforming and expanding diagnostic services and speeding up waiting times for tests, a crucial part of reducing overall waiting times and returning to the RTT standard. This includes investment in Community Diagnostic Centres (CDCs), expanding the number of CDCs operating seven days a week and 12 hours a day, as well as the tests they offer. We will also develop and roll out Straight to Test pathways, reducing the time taken for patients to receive a test, as well further improvements to the NHS’ digital capabilities. An investment of approximately £1.5 billion, as announced in the Autumn Budget, will enable diagnostics services to build on these foundations in 2025/26, to ensure diagnostic services are fit for the future. This will ensure that patients receive the diagnostic care where and when they need it, including for subtype diagnoses.