Written questions by Hayes.

Whether he plans to publish a review of the potential costs to the NHS of changes to the law on assisted dying.

There is no review of the potential costs to the National Health Service of changes to the law on assisted dying and accordingly, there are no plans to publish a review.

If he will make an assessment of the impact of the increase in employers’ National Insurance contributions on care 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. This assessment took into account a wide range of factors, including changes to employer National Insurance contributions, and the National Living Wage increases. No specific assessment has been made on the impact of an increase to employer National Insurance contributions on care home providers.In response to the range of pressures facing local authorities, the Government is providing a real-terms uplift to core local government spending power of approximately 3.2%, which includes £1.3 billion of new grant funding in 2025/26.

If he will make an assessment of the impact of the increase in employers’ National Insurance contributions on hospices.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, which enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The employer National Insurance contributions rise will be implemented in April 2025, and the Department will set out further details on the allocation of funding for next year in due course.

How many and what proportion of care homes in South Holland and the Deepings constituency are rated (a) good and (b) excellent by the Care Quality Commission.

There are currently 36 care homes registered with the Care Quality Commission in South Holland and The Deepings constituency. Data from 1 November 2024 shows that two care homes, or 6%, are rated Outstanding, and 24 care homes, or 67%, are rated Good.

If he will take steps to increase funding for brain injury reablement services in rural areas.

The Government wants a society where every person, including those with a long-term condition such as an acquired brain injury (ABI), receives high-quality, compassionate continuity of care, with their families and carers supported.We will change the National Health Service so that it becomes not just a sickness service, but one able to prevent ill health in the first place. This will help us be better prepared for the change in the nature of disease and allow our services to focus more on the management of chronic, long-term conditions, like ABIs, including rehabilitation where appropriate.A decision on the next steps on ABIs at the national level will be taken in the coming months. Meanwhile, we have committed to develop a 10-year plan to deliver an NHS fit for the future. We will be carefully considering input from the public, patients, health staff, and our stakeholders as we develop the plan over the coming months. The engagement process has been launched and I would encourage my fellow Parliamentarians to engage with that process, to allow us to fully understand what is not working as well as it should and what the potential solutions are, including on ABI. More information about how they can input into the plan is available at the following link:https://change.nhs.uk/en-GB/Integrated care boards (ICBs) are responsible for commissioning services such as rehabilitation and reablement services, and ensuring that there is appropriate provision to meet the health and care needs of their population. The core ICB allocations formula is an estimate of the relative need for healthcare resources in each ICB, and is recommended by an independent committee. The formula includes a range of adjustments that account for the fact that the costs of providing health care may vary between rural and urban areas.Often, rehabilitation and reablement services don’t provide services exclusively for patients with brain injuries, but also provide rehabilitation for patients with other conditions, such as stroke and Parkinson’s disease. Therefore, it is difficult to quantify the total about of funding that is spent on brain injury reablement services specifically.

What the average waiting time is to register with an NHS dentist in Lincolnshire.

Patients in England are not registered with a National Health Service dental practice and there is no single waiting list, although many NHS dental practices do tend to see patients regularly and may operate local waiting list arrangements.The responsibility for commissioning primary care, including dentistry, to meet the needs of the local population has been delegated to all integrated care boards (ICBs) across England. For the South Holland and The Deepings constituency, this is the NHS Lincolnshire ICB.

What the average waiting time is for a dementia assessment in (a) South Holland and the Deepings constituency and (b) Lincolnshire.

The constituency in question is split across two Older People Community Mental Health Teams (CMHT), Stamford and Spalding CMHTs. Whilst this does not map exactly with the constituency area, the average wait for the first appointment across the two CMHTs is 11.62 weeks.Lincolnshire Partnership NHS Foundation Trust (LPFT) has received funding to introduce a specific pathway for memory assessments, which will help tackle local waiting times for assessment and diagnosis of conditions such as dementia. Work is underway to finalise the model of care and to launch it towards the end of the financial year.There has been continued LPFT recruitment funding for dedicated Memory Assessment Practitioners with increased assessment and diagnostic output, as well as recruitment for additional, dedicated Memory Assessment Service Consultants to increase diagnostic capacity.

How many NHS patients have been treated with Spinraza in (a) Lincolnshire and (b) the East Midlands since 2019.

Use of nusinersen, also known by the brand name Spinraza, is commissioned from specialist centres, and in the East Midlands the service is commissioned from Nottingham University Hospital (NUH). NUH has treated eight patients with nusinersen since 2019. No patients were treated in Lincolnshire hospitals, as there is no specialist centre there.

What steps he is taking to help improve ambulance response times in (a) South Holland and the Deepings constituency and (b) Lincolnshire.

The Government has committed to supporting the National Health Service to improve performance and achieve the standards set out in the NHS Constitution, including for ambulance response times. This will improve the level of service nationally, in Lincolnshire and in South Holland and the Deepings.As a first step, my Rt Hon. Friend, the Secretary of State for Health and Social Care appointed Professor Lord Darzi to lead an independent investigation of the NHS’ performance. The investigation’s findings were published on 12 September and will feed into the Government’s work on a 10-Year Health Plan to radically reform the NHS and build a health service that is fit for the future.Ahead of this winter, NHS England has set out the priorities for the NHS to maintain and improve patient safety and experience, including actions to support patient flow and ensure ambulances are released in a timely way. NHS England’s winter letter is available at the following link: https://www.england.nhs.uk/long-read/winter-and-h2-priorities/

If he will make an estimate of the waiting times for (a) assessments for and (b) diagnoses of autism in (i) adults and (ii) children in (A) South Holland and the Deepings constituency and (B) Lincolnshire.

The information requested is not held centrally, but may be held by individual providers or integrated care boards (ICBs). Some relevant information is available on autism assessment waiting times for the NHS Lincolnshire ICB. In the NHS Lincolnshire ICB in June 2024, the Autism Waiting Time Statistics show that there was a total of 1,455 patients with an open suspected autism referral. 55 of these patients were aged zero to 17 years old, and 1,405 of these patients were aged 18 years old and over. Since each metric is rounded to the nearest five in the published data, the number of adults and children do not add up to the total number of patients.The median waiting time of all patients in this ICB with an open suspected autism referral, where their first care contact was in the quarter, was 232 days for over 18-year-olds. For zero- to 17-year-olds, the median number of days patients waited was not able to be provided, due to a small sample size of the number of children who had their first care contact in the most recent quarter.Data on children and young people in this dataset is expected to be an underestimate and caution should be used when interpreting these statistics, since they are experimental rather than official statistics. The majority of children assessed for autism in the United Kingdom are seen in child development services, which are out of the scope of this dataset. This means the published figures will underestimate the volume of referrals or diagnoses and the associated impact on health services. NHS England continues to conduct exploratory analysis into the Community Services Dataset, with a view to including autism waiting times data from that dataset.

If he will set up a cross-departmental working group to discuss how to increase the fertility rate.

We currently have no plans to set up any working groups to discuss how to increase the fertility rate.

What steps his Department is taking to improve maternity services in Lincolnshire.

The Department is supporting the National Health Service to deliver the three-year delivery plan for maternity and neonatal services across England, to make care safer, more personalised, and more equitable for women and babies.In Lincolnshire, there have been recent improvements to perinatal pelvic health services, as well as implementation of the updated Saving Babies Lives Care Bundle, a package of interventions to reduce stillbirths, neonatal brain injury, neonatal deaths, and preterm birth.The Midlands Heatmap Data, a tool for assessing maternity and neonatal care safety and quality, has shown a significant improvement, with Lincolnshire being the best performing in the region in August 2024.

What steps his Department is taking to improve the dementia diagnosis rate in (a) South Holland and the Deepings constituency and (b) Lincolnshire.

The national target for dementia diagnosis is that 66.7% of the prevalent population has a diagnosis of dementia. Lincolnshire is at 67.8% because of prioritising improvements in diagnosis rates.Lincolnshire Partnership NHS Foundation Trust (LPFT) have set up a Dementia Diagnosis Rate (DDR) working group established with action plan to drive forward DDR recovery. This includes improving LPFT data and using the Population Health Management tool to identify any discrepancies with practice dementia registers.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.

What steps he is taking to increase the number of radiotherapy treatment machines in England.

The Government knows that cancer patients are waiting too long for a diagnosis and treatment. We will get the National Health Service diagnosing cancer on time, diagnosing it earlier, and treating it faster, so that more patients survive this horrible set of diseases, and we will improve patients’ experience across the system. As part of this, we are committed to bringing down waits for cancer appointments with a Fit for the Future fund, providing investment for the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce elective and cancer waiting times, thereby saving lives.The Government will continue to support the provision of radiotherapy machines, however, since April 2022 the responsibility for investing in new radiotherapy machines has been with local systems.

If he will have discussions with NHS England on improving access to radiotherapy treatments for cancer patients in rural areas.

NHS England and the integrated care boards are responsible for ensuring that the healthcare needs of local communities are met. These responsibilities include considering adequate healthcare provision, care, and wider support for local populations, including in remote and rural areas.For those who may struggle to access treatment, the NHS Healthcare Travel Costs Scheme provides financial assistance to patients in England who do not have a medical need for transport, but who require assistance with the costs of travelling to receive certain National Health Services. The NHS Non-Emergency Patient Transport Services provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.

Whether Ministers in his Department have met representatives of the Mermaids charity since 5 July 2024.

Ministers from the Department have not met with representatives of the Mermaids charity since 5 July 2024.

If he will make an estimate of the number of unpaid carers in South Holland and the Deepings constituency.

The 2021 Census found that there are approximately 4.7 million people of all ages in England who said they provided unpaid care. In the South Holland and the Deepings constituency, the census showed that there were approximately 9,700 people of all ages who said they provided unpaid care.

What steps his Department is taking to improve breast cancer screening in (a) Lincolnshire and (b) South Holland and The Deepings constituency.

Nationally, NHS England has developed a national plan in collaboration with key stakeholders, such as cancer alliances, to improve uptake within the breast screening programme. The plan sets out the priorities, interventions, and the required monitoring of the impacts and outcomes to be achieved, to improve uptake through expanding access, data, and analytics, reducing inequalities, contracting, communication, and IT developments.Locally, the Lincolnshire Integrated Care Board was awarded national funding in 2023 to establish an additional mobile screening unit. Additionally, local services are doing focused inequalities work with three practises identified as having lower uptake.

What steps his Department is taking to prevent migrants who are not entitled to use NHS services from using (a) hospitals, (b) GP services and (c) other NHS services.

Anyone can access and use the National Health Service, however some individuals who are not ordinarily resident or not covered by an exemption under the NHS (Charges to Overseas Visitors) Regulations 2015, will be chargeable for some NHS services, as the NHS is a residency-based system. Services, such as those provided by a general practice, or services provided for the diagnosis of infectious diseases, are exempt from charge for all. Where treatment is urgent, as determined by a clinician, that treatment will never be delayed, and if charges apply, they must be pursued by the NHS trust after treatment.

What recent estimate he has made of the number of people in (a) South Holland and the Deepings constituency and (b) Lincolnshire who have unmet care needs; and what steps his Department is taking to help ensure those care needs are met.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs. Where individuals do not meet the eligibility threshold, they can get support from their local authorities in making their own arrangements for care services, as set out in the Care Act 2014.Long-term reform is needed in adult social care. We will work with the sector to build consensus for a National Care Service, based on consistent national standards, to support people to live independent and dignified lives.In the interim, Care Quality Commission (CQC) local authority assessments consider the performance of the delivery of Care Act duties, including the timeliness of assessing care needs. If the CQC identifies that a local authority has failed or is failing its functions to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care has powers to intervene. The CQC has published its first nine local authority ratings and reports.