Written questions by Reynolds.

What steps his Department is taking to ensure that endometriosis is adequately covered in the education and training of healthcare practitioners.

The Government acknowledges the challenges faced by women with endometriosis and the impact it has on their lives, their relationships, and their participation in education and the workforce.The Government also acknowledges the importance of ensuring healthcare professionals are adequately trained and educated on women’s health conditions, including endometriosis, and we have taken action to address this.The General Medical Council (GMC) has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems among all doctors as they start their careers in the United Kingdom. The content for this assessment includes several topics relating to women’s health including endometriosis.Women's health is included the Royal College of General Practitioners (RCGP) curriculum for trainee general practitioners (GPs), including gynaecology, sexual health, and breast health. The curriculum also covers the healthcare needs of women across all diseases seen in primary care as it is important women are treated holistically. This ensures that all future GPs receive education on women’s health.The RCGP has also published a Women’s Health Library which brings together educational resources and guidelines on women’s health from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the College of Sexual and Reproductive Healthcare. This resource is continually updated to ensure GPs and other primary healthcare professionals have the most up-to-date advice to provide the best care for their patients.The National Institute for Health and Care Excellence has developed a women’s and reproductive health topic suite, and updated guidelines on endometriosis in 2024 to make firmer recommendations for healthcare professionals on referral and investigations for women with suspected diagnosis. These clinical guidelines support healthcare professionals to provide care for women with endometriosis.Generally, employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver appropriate treatment for patients.

What level of recurrent funding has been identified to fund new treatments through NHS England’s Clinical Priorities Advisory Group Prioritisation meeting.

The Clinical Priorities Advisory Group is an advisory committee that makes recommendations on the relative priority of treatments to be commissioned subject to the available discretionary funding. It is not a decision-making body and does not allocate funds or have a budget for approving new treatments. Further information is available at the following link:https://www.england.nhs.uk/commissioning/cpag/

What steps he is taking to reduce the backlog for NHS England’s Clinical Priorities Advisory Group Prioritisation meeting.

The next Clinical Priorities Advisory Group (CPAG) prioritisation meeting is planned for spring 2026, where policies that are ready and require investment decisions to be taken will be considered. It is expected up to 20 such policies will be considered at the next meeting.CPAG also continues to meet monthly to consider policy and service specifications that are categorised as cost saving or cost neutral.

How many times NHS England’s Clinical Priorities Advisory Group Prioritisation meeting happens each year; and when the next meeting will be.

NHS England’s Clinical Priorities Advisory Group (CPAG) meets monthly to consider policy and service specifications that are categorised as cost saving or cost neutral. CPAG prioritisation meetings are held annually. The next prioritisation meeting is planned for spring 2026.

If he will make an assessment of the potential impact of the UK-US Pharmaceuticals Deal concluded in December 2025 on (a) NHS procurement costs and (b) consumer access to affordable medicines before any provisions of that Deal take effect.

There are no current plans to publish an impact assessment or modelling on the United Kingdom and United States’ pharmaceutical trade deal. Further detail on the deal will be shared in due course.Tens of thousands of National Health Service patients will benefit from this deal, which will secure and expand access to vital drugs, and thereby safeguard our medicines supply chain.Costs will start smaller but will increase over time as the National Institute for Health and Care Excellence (NICE) approves more life improving and lifesaving medicines. Total costs over the Spending Review period are expected to be approximately £1 billion. The final costs will depend on which medicines NICE recommends and the actual uptake of these.This deal is a vital investment that builds on the strength of our NHS and world leading life sciences sector, without taking essential funding from our frontline NHS services.

What the process is for evaluating new medical devices for the treatment of chronic neuropathic pain conditions for use in the NHS.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusions on the market in the United Kingdom are safe, effective, and manufactured to the highest standards of quality. The Medical Devices Regulations 2002 (MDR 2002) established the statutory framework that medical devices must meet in order to comply with these standards. All medical devices, including those used for treatment of chronic neuropathic pain conditions, must comply with the MDR 2002, which include bearing the UKCA or CE marking on the packaging or labelling of the device. Manufacturers or their United Kingdom based representatives must monitor use of these devices when used in the UK. The MHRA does not grant clearance or approval for medical devices, outside of exceptional circumstances. The manufacturer holds the legal responsibility for obtaining the necessary certification and registering their medical devices with MHRA, the UK competent authority. Higher risk medical devices are assessed and approved by Approved Bodies in the UK or Notified Bodies in the European Union. The MHRA is not responsible for the procurement aspects of the NHS organisations, as that is outside the MHRA’s remit.

Whether NICE has been asked to evaluate Scrambler Therapy for the treatment of Complex Regional Pain Syndrome.

The National Institute for Health and Care Excellence (NICE) has not been asked to evaluate scrambler therapy for complex regional pain syndrome. Topics for new or updated guidance are considered through the NICE prioritisation process and under this process, decisions as to whether NICE will create new, or update existing, guidance are overseen by an integrated, cross-organisational Prioritisation Board, chaired by NICE’s Chief Medical Officer. The Prioritisation Board has been made aware of scrambler therapy, and the topic is likely to be considered by the board in the first quarter of 2026. Any decision or updates will appear on the prioritisation pages of the NICE website in due course, with further information available at the following link:https://www.nice.org.uk/what-nice-does/our-guidance/prioritising-our-guidance-topics

What steps he plans to take to ensure that the final statutory guidance issued under the Down Syndrome Act 2022 includes explicit requirements for Down syndrome-specific training for professionals in health, education and social care sectors.

Under the Down Syndrome Act, my Rt Hon. Friend, the Secretary of State for Health and Social Care, is required to give statutory guidance to relevant authorities in health, social care, education, and housing services on what they should be doing to meet the needs of people with Down syndrome. The consultation on the draft guidance was launched on 5 November 2025 and will remain open until 30 March 2026.Relevant authorities, as defined in the schedule to the act, have a duty to have due regard to the final guidance once it is published. The act does not create any new functions beyond this duty. Rather, it brings together existing statutory requirements and guidance that relevant authorities must and/or should already be complying with to support people with Down syndrome and people with other conditions and/or a learning disability who have similar needs.Under existing legislation, Care Quality Comision registered providers must ensure that staff receive appropriate professional development which is necessary for them to carry out their duties and must receive specific training on learning disability and autism appropriate to their role, as per Section 20 of the Health and Social Care Act 2008, Section 181(7) of the Health and Care Act 2022 and Regulation 18 of the Health and Social Care Act 2008 Regulated Activities) Regulations 2014. We expect that providers should be considering whether specific training on Down syndrome is required for their staff, and the draft guidance under the Down Syndrome Act sets out that some staff who work frequently with people with Down syndrome may require additional training on Down syndrome.

What assessment he has made of the potential impact of Scotland's proposed regulation of non-surgical cosmetic procedures on England's regulatory framework; and, with reference to his Department's document entitled The licensing of non-surgical cosmetic procedures in England: consultation response, updated on 7 August 2025, what the timeline is for implementing the measures in that document.

On 7 August 2025, the Government announced its plans to introduce measures to improve the safety of the cosmetics sector. This included prioritising the introduction of legal restrictions which will ensure that the highest risk cosmetic procedures are brought into Care Quality Commission regulation and can only be performed by specified regulated healthcare professionals.In addition, the Government also committed to legislating to introduce a licensing scheme in England for lower risk procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed. To protect children and young people, the Government is also committed to mandating age restrictions for cosmetic procedures.The proposals will be taken forward through secondary legislation and therefore will be subject to the parliamentary process before the legal restrictions, or licensing regulations, can be introduced. We are now working with stakeholders to develop detailed plans and intend to consult on proposals for restrictions around the performance of the highest risk procedures in the spring.We are aware that the Scottish Government is bringing forward its own legislation to introduce measures to protect the public in Scotland from unsafe cosmetic practises. We will continue to work closely with the Scottish Government to foster opportunities for further collaboration and alignment.

With reference to his Department's document entitled The licensing of non-surgical cosmetic procedures in England: consultation response, updated on 7 August 2025, what progress has been made on implementing the proposals outlined in that document; and if he will set out the timeline for introducing regulatory measures for non-surgical cosmetic procedures.

On 7 August 2025, the Government announced its plans to introduce measures to improve the safety of the cosmetics sector. This included prioritising the introduction of legal restrictions which will ensure that the highest risk cosmetic procedures are brought into Care Quality Commission regulation and can only be performed by specified regulated healthcare professionals.In addition, the Government also committed to legislating to introduce a licensing scheme in England for lower risk procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed. To protect children and young people, the Government is also committed to mandating age restrictions for cosmetic procedures.The proposals will be taken forward through secondary legislation and therefore will be subject to the parliamentary process before the legal restrictions, or licensing regulations, can be introduced. We are now working with stakeholders to develop detailed plans and intend to consult on proposals for restrictions around the performance of the highest risk procedures in the spring.We are aware that the Scottish Government is bringing forward its own legislation to introduce measures to protect the public in Scotland from unsafe cosmetic practises. We will continue to work closely with the Scottish Government to foster opportunities for further collaboration and alignment.

What data his Department holds on average working hours for midwives at NHS trusts serving the Maidenhead constituency; and what consideration he has given to introducing legal limits on midwives' working hours to help improve workforce retention and patient safety.

The Department has access to very limited data on paid working hours under an individual’s substantive contract. This data is not a reliable way to measure average working hours since it leaves out work done through bank or agency roles, any work outside the hospital and community health services sector, and “discretionary” work that is unpaid.Employers have a duty of care to consider staff rights and wellbeing when balancing the demands of around the clock care in the best interest of patients and the rules around working hours, rest breaks, and paid leave as set out in the Working Time Regulations 1998. In general, the safeguards relating to working hours under National Health Service staff terms and conditions of service are stronger than the legal minimums. Working hours and shift expectations are made clear in employees’ contracts of employment. Certain exemptions may apply during emergencies or other unforeseeable events, allowing some rules to be changed or excluded under collective agreements. Employers have local arrangements agreed with trade unions and staff, to address modifications in the event of emergencies.

What progress has been made in implementing workforce recommendations from the National Maternity and Neonatal Taskforce; and what measures are being taken to help tackle (a) midwife burnout and (b) midwifes working too many hours at maternity services serving Maidenhead constituents.

The health and wellbeing of our National Health Service staff, including midwives, is a top priority.The independent National Maternity and Neonatal Investigation, chaired by Baroness Amos, is expected to publish findings in the Spring. My Rt Hon. Friend, the Secretary of State for Health and Social Care, will chair the National Maternity and Neonatal Taskforce to address the recommendations and develop a new national action plan to drive improvements across maternity and neonatal care.As set out in the 10-Year Health Plan, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment.It is for local NHS trusts to determine what working patterns may be required to meet local service needs in the interest of patients, considering the provisions set out in the Working Time Regulations 1998.

What assessment he has made of the fairness of the current means tested social care system for people with dementia in cases where individuals are required to sell their homes or exhaust lifetime savings to fund care.

The adult social care system is means tested and provides funded support for those with the least financial means. While the Department sets the minimum thresholds for accessing local authority support, local authorities have the discretion to set more generous thresholds if they choose.Individuals are not required to sell their home to pay for care if they, their spouse, or another eligible relative still lives there, as the property is disregarded in the financial assessment. In cases where a person’s property is included in the financial assessment, the universal deferred payment agreement (DPA) scheme means that the person should not be forced to sell their home in their lifetime to pay for their care. By entering into a DPA, a person can defer paying the costs of their care and support in a care home until a later date.The Government has launched an Independent Commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will deliver recommendations for the transformation of adult social care, addressing demographic change, how services should be organised to deliver this, and how to best create a fair and affordable adult social care system.

What steps he is taking to prevent sudden cardiac deaths in people aged 35 and under.

To reduce the risks of sudden cardiac death, NHS England has published a national service specification for inherited cardiac conditions which includes services for young adults with previously undiagnosed cardiac disease. NHS England is currently reviewing this service specification and is working with a broad range of stakeholders as part of the review.

Whether he will review the current eligibility criteria for NHS-funded COVID-19 vaccinations, in light of the emergence of a new variant and rising hospitalisations.

The Joint Committee on Vaccination and Immunisation carefully considered the latest evidence on the risk of hospitalisation and mortality in specific groups, as well as cost-effectiveness analysis, in order to provide the Government with advice on the autumn 2025 programme. The evidence indicates that whilst the risk from COVID-19 is now much lower for most people, adults aged 75 years old and over, residents in care homes for older adults, and those who are immunosuppressed are those at highest risk of serious COVID-19 disease.Therefore, a more targeted vaccination programme aimed at individuals with a higher risk of developing serious disease, and where vaccination was considered potentially cost-effective, was advised for autumn 2025.The latest UK Health Security Agency’s (UKHSA) data in the national flu and COVID-19 surveillance report supports the current eligibility, showing that there is a strong association between age and COVID-19 hospitalisation rates. The highest hospital admission rate for COVID-19 in the report published on 27 November 2025 was in those aged 85 years old and over.Currently XFG and its sub lineages, sometimes called the ‘Stratus’ variant, are the most prevalent SARS-CoV-2 lineages in England. This lineage is closely related to previous variants that circulated in the United Kingdom. At this time there is no indication that XFG causes more serious disease, or that the vaccines being used in the autumn 2025 campaign will not be effective against it. The UKHSA will continue to monitor both COVID-19 outcomes and variant prevalence as we enter the winter season.

When he plans to respond to question 81028, tabled on 10 October 2025.

I refer the hon. Member to the answer I gave on 1 December 2025 to Question 81028.

What assessment his Department has made of the suitability of the National Institute for Health and Care Excellence’s approach to evaluating the cost-effectiveness of rare disease medicines.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.

What steps his Department is taking in response to research by the UK BioIndustry Association published on 6 November 2025 showing that around half of rare disease medicines approved by the European Medicines Agency (EMA) are not being reimbursed for patients in England.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.

What steps his Department is taking to ensure that people living with rare diseases in England have timely access to innovative medicines.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE plays a key role in supporting the adoption of innovative new medicines to improve outcomes for patients, at a price that reflects their value and is fair to the taxpayer.NICE has a strong track record of recommending medicines for the treatment of rare diseases and its standard technology appraisal process has been proven to be suitable for the evaluation of these medicines, where companies engage constructively in the appraisal and commercial discussions with NHS England. NICE’s approval rate for medicines for rare diseases is in line with its overall approval rate for new medicines, with 91% of medicines licensed for rare diseases recommended for some or all of the eligible patient population since April 2024.NICE’s also operates a separate highly specialised technologies programme (HST) which is reserved for a small number of medicines for very rare and very severe diseases. The HST programme uses a much higher cost-effectiveness threshold than a standard NICE appraisal, that recognises the challenges of developing medicines for very small patient populations.The Government remains committed to improving the lives of people living with rare diseases through the UK Rare Diseases Framework, which includes improving access to specialist care, treatment, and drugs as one of its four priorities. We are committed to ensuring that this priority is a key driver of the action plans published under this framework.

If his Department will commit to appointing a new National Clinical Director for Rare Diseases.

Working under the UK Rare Diseases Framework the Government is committed to improving the lives of those living with rare diseases. NHS England and the Department are strongly supportive of clinical leadership and recognise that national clinical directors play an important role in policy development and implementation. There are over 7,000 types of rare disease which span the range of clinical specialities. As such, NHS England and the Department expect to continue to draw upon the range of clinical expertise that their national clinical directors hold to inform our work in this area, as well as that of expert clinicians delivering services for rare diseases, such as those commissioned by specialised commissioning. In addition, there is a National Medical Director for Specialised Services who provides national leadership and advice for the healthcare of rare disease and oversight for the portfolio of rare diseases which NHS England commissions services for.