Written questions by Buckley.

Whether there are plans to allow the electronic transfer of GP records when people move from Wales to England.

Awaiting answer.

What assessment he has made of the potential impact of the Hospital Transformation Programme on the Royal Shrewsbury Hospital.

Thank you to my hon. friend for championing this important Programme, which is delivering £312 million of investment in local services.The construction of a new four-storey building at the Royal Shrewsbury Hospital will mean a bigger, improved emergency department with faster access for patients to the right care and with improved staff experience.

What steps his Department is taking to help improve the provision of healthy food options in hospital vending machines.

National Health Service hospitals are required to meet the Government Buying Standards for Food and Catering Services through the NHS Standard Contract. They are also required to develop and maintain a food and drink strategy which focuses on healthier eating across the whole hospital community, including for their vending machines.

Whether there are mandatory timescales for (a) nursing homes requesting an assessment for (i) continuing healthcare funding and (ii) funded nursing care and a checklist referral being completed and (b) checklist referrals for (A) continuing healthcare funding and (B) funded nursing care being completed and full assessments being completed.

The statutory guidance, National framework for NHS continuing healthcare and NHS-funded nursing care, sets out the principles and processes for NHS Continuing Healthcare (CHC) and National Health Service-funded nursing care (FNC), so that people are assessed and receive care in a timely way. Further information on the statutory guidance is available at the following link:https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-careThe national framework sets the expectation that the overall assessment and eligibility decision-making process for CHC should, in most cases, not exceed 28 calendar days, from the date that the integrated care board receives the positive checklist, to the eligibility decision being made. There are no mandatory timescales for the completion of a CHC checklist referral when requested by a nursing home. There are no mandatory timescales for a decision to be made about FNC eligibility.

What steps his Department is taking to increase the availability of GP appointments.

The Government is determined to fix the front door of our National Health Service, making it easier for everyone to see a general practitioner (GP) when they need to.In October 2024, we injected £82 million into the Additional Roles Reimbursement Scheme to enabling the recruitment of 1,000 newly qualified GPs across England, which will increase the number of appointments delivered and care for thousands of patients.We’ve just delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of NHS resources. For the first time in four years, the General Practitioners Committee England backed the new 2025/26 contract, which includes key reforms to improve access, for instance by making sure that patients can request appointments online throughout core hours.

What assessment his Department has made of trends in the level of regional inequalities of access to GP appointments.

We are committed to improving capacity and access to local services across the country. Integrated care boards (ICBs) and general practices (GPs) have a statutory duty to ensure sufficient provision of medical services, tailored to the needs of their local populations, accounting for factors like population growth, deprivation, and demographic change.While GPs operate as independent contractors, they are held to nationally agreed standards under the GP Contract, which is reviewed and improved annually. The 2024/25 contract is backed by the largest increase in GP funding in years, specifically an £889 million uplift. This investment supports key reforms to improve access across the country, including a new requirement for practices to offer online appointment requests throughout core opening hours.We will continue working closely with ICBs to monitor and address variations in access, so that every patient can get the care they need, when they need it.

What the average waiting time is for a hip replacement.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

What recent steps his Department has taken to reduce hip replacement waiting lists.

People have been waiting too long for National Health Service treatment, with their personal and professional lives put on hold. This is why we have committed to getting back to the NHS constitutional standard, that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT) by March 2029. This includes patients waiting for hip replacement surgery, for which the median average waiting time in England as of 16 March 2025 was 24.7 weeks.We have already made progress, delivering on our commitment to provide two million additional appointments and publishing our Elective Reform Plan, which sets out how we will tackle waits, increase productivity, and improve patient experience. This includes providing quicker access to common surgical procedures, such as hip replacements, by opening 17 new and expanded surgical hubs by June 2025, so more operations can be carried out.Dedicated and protected surgical hubs are transforming the way the NHS provides elective care by focusing on high volume low complexity surgeries. There are currently 114 elective surgical hubs that are operational across England as of March 2025, with 88 of them providing treatment for the trauma and orthopaedic specialty under which hip replacements fall. These surgical hubs help separate elective care facilities from urgent and emergency care, improving outcomes for patients and reducing pressures on hospitals.

What steps his Department is taking to improve provision of mental health services to acute mental health patients leaving in-patient facilities.

The statutory guidance on discharge from mental health inpatient settings makes clear that National Health Service mental health trusts should have a clear plan in place for the ongoing care and support that a patient requires after discharge from a mental health inpatient setting. This should cover their pharmacological, physical health, psychological, social, cultural, education, housing and finances, and any other individual needs or wishes.Individual trusts providing mental health inpatient services are expected to closely monitor hospital discharge performance data to ensure discharge arrangements are operating effectively and safely across the system and are also subject to monitoring, inspection and regulation by the Care Quality Commission (CQC).In response to the CQC’s review of the care and treatment provided to Valdo Calocane and of services provided by Nottinghamshire Healthcare NHS Foundation Trust, NHS England asked every provider of mental health services to review the care received by people with serious mental illness who require intensive community treatment and follow-up but where engagement is a challenge.Alongside this, NHS England is also developing new core standards of care for community mental health services to support the continued improvement of care.As part of our mission to build an NHS that is fit for the future and shift care from hospitals into the community by improving community and crisis services, NHS England is piloting new models of care in the community for those with the most serious mental illnesses. New mental health centres open in six neighbourhood areas from this spring and will provide people and their families with support 24 hours a day, seven days a week, if they are in crisis without needing to book an appointment, as well as provide housing or employment advice to support them to stay well. A key feature of the model is continuity of care whereby the same team will support people with serious mental illnesses throughout all stages of their interaction with services, including transitions between hospital and the community.The Mental Health Bill, currently before Parliament, also aims to strengthen discharge arrangements for people detained in hospital under the Mental Health Act.

Whether his Department monitors the quality of support provided by NHS trusts to people with acute mental health conditions when they leave in-patient care.

The statutory guidance on discharge from mental health inpatient settings makes clear that National Health Service mental health trusts should have a clear plan in place for the ongoing care and support that a patient requires after discharge from a mental health inpatient setting. This should cover their pharmacological, physical health, psychological, social, cultural, education, housing and finances, and any other individual needs or wishes.Individual trusts providing mental health inpatient services are expected to closely monitor hospital discharge performance data to ensure discharge arrangements are operating effectively and safely across the system and are also subject to monitoring, inspection and regulation by the Care Quality Commission (CQC).In response to the CQC’s review of the care and treatment provided to Valdo Calocane and of services provided by Nottinghamshire Healthcare NHS Foundation Trust, NHS England asked every provider of mental health services to review the care received by people with serious mental illness who require intensive community treatment and follow-up but where engagement is a challenge.Alongside this, NHS England is also developing new core standards of care for community mental health services to support the continued improvement of care.As part of our mission to build an NHS that is fit for the future and shift care from hospitals into the community by improving community and crisis services, NHS England is piloting new models of care in the community for those with the most serious mental illnesses. New mental health centres open in six neighbourhood areas from this spring and will provide people and their families with support 24 hours a day, seven days a week, if they are in crisis without needing to book an appointment, as well as provide housing or employment advice to support them to stay well. A key feature of the model is continuity of care whereby the same team will support people with serious mental illnesses throughout all stages of their interaction with services, including transitions between hospital and the community.The Mental Health Bill, currently before Parliament, also aims to strengthen discharge arrangements for people detained in hospital under the Mental Health Act.

What steps he is taking to ensure local authorities complete timely financial audits of social care providers.

Adult social care services are provided through a largely outsourced market of commercial organisations and charities. Local authorities are best placed to understand and plan for the care needs of their populations, and to develop and build local market capacity.That is why, under the Care Act 2014, local authorities are required to shape their local markets, and ensure that people have a range of high-quality, sustainable, and person-centred care and support options available to them, and that they can access the services that best meet their needs.Local authorities also have a duty under the Care Act 2014 to ensure continuity of care in the event of business failure. This means that people continue to receive the care and support they need if their adult social care provider is no longer able to carry on delivering services.

If he will amend the key performance indicator for waiting times for children’s mental health services to include the length of time between referral and the start of treatment.

NHS England is working towards implementing the clinical review of standards and as a first step have started publishing data on waits from referral to start of treatment.

What steps he is taking to help improve waiting times for children’s mental health services.

Too many children and young people are not receiving the mental health care they need, and we know that waits for mental health services are too long. As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, we will recruit an additional 8,500 mental health workers across child and adult mental health services in England to cut waiting times and ensure that people can access treatment and support earlier. We will also provide access to a specialist mental health professional in every school in England and introduce open access Young Futures hubs in every community.

What assessment his Department has made of the adequacy of access to shared care arrangements for adults diagnosed with ADHD.

We are supporting a cross-sector taskforce that NHS England has established to look at attention deficit hyperactivity disorder (ADHD) service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the National Health Service, education and justice, to better understand the challenges affecting people with ADHD including timely access to services and support.General practitioners (GPs) are independent contractors that provide services for the National Health Service. The General Medical Council has published guidance on “Good practice in proposing, prescribing, providing and managing medicines and devices content”. This includes guidance on shared care arrangements between a specialist service and the patient’s GP to help GPs decide whether to accept shared care responsibilities for any condition. The guidance is available at the following link:https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-careNHS clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds.If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician; this applies to both NHS and private medical care.

What assessment he has made of waiting times for children’s mental health services, between the point of initial assessment and starting treatment.

No such assessment has been made, as the Mental Health Services Data Set does not collect data from ‘initial assessment to starting treatment’.

Whether he has made an assessment of the potential impact of the increase in employers' National Insurance contributions on non-profit social care providers for under 65s.

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. 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. Overall, core local government spending power is increasing by 6.8% in cash terms.

Whether his Department has made an assessment of the potential merits of preventative impact of ear wax removal on the NHS for children presenting with hearing loss.

In line with National Institute for Health and Care Excellence (NICE) guidance, an adult or child may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A general practice could then consider referring the patient into audiology services. The patient's clinician is best placed to make this assessment. The NICE has published guidelines on hearing loss, and specifically on ear wax removal treatment, which is available at the following link:https://www.nice.org.uk/guidance/ng98/chapter/Recommendations#removing-earwax

What steps his Department is taking to help ensure that measures to improve the management of long-term conditions are included within the NHS 10 year plan.

The number of individuals living with long term conditions is expected to rise significantly over the next decade. Currently, the National Health Service operates a model focused on treating acute episodes, organised around fragmented services rather than holistic patient needs. To ensure the NHS is fit for the future, we must improve care for those with long-term conditions.One of the working groups supporting the development of the 10-Year Health Plan has been asked to develop a vision for how the NHS can evolve to provide responsive, joined-up care to better support individuals with complex health needs, who may require frequent, ongoing engagement with the NHS. The group, chaired by Dr Claire Fuller and Caroline Abrahams CBE, will consider what improved care would look like for both individuals living with a single, or multiple long-term conditions, including, for example, mental health conditions, or disabilities, as well as individuals with multiple complex needs, including those that are frail or approaching the end of their life.Starting with the patient perspective, we have asked this group to consider what people of all ages want and need from services across the NHS to manage their condition or conditions on an ongoing basis, and what the care offer should look and feel like in practice, so that the NHS can empower patients, enhance their self-management capabilities, and promote independence through a holistic, person-centred and responsive service.

Whether his Department will make an assessment of the adequacy of NHS targets for incentivising improvement in patient experience.

The Government is committed to putting patients first, ensuring that they are seen on time, and that they have the best possible experience while they wait for care. Although no specific assessment has been made of the adequacy of National Health Service targets for incentivising improvement in patient experience, the Government is committed to making improvements. We have an ambitious set of targets that will tackle issues that matter to patients, including returning to the NHS Constitutional standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment.We also want to improve experience for patients living with complex, long-term, or serious illnesses, like cancer. We are committed to meeting all three NHS cancer waiting time standards across England, so that no patient waits longer than they should for cancer diagnosis or treatment.

What steps his Department is taking to help improve data collection on the (a) prevalence and (b) impact on (i) public health and (ii) the NHS of long-term health conditions.

The Government wants a society where every person, including those with a long-term condition, and their families and carers, receives high-quality, compassionate continuity of care. 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.Integrated care boards (ICBs) are responsible for commissioning most services for people with long term conditions. ICBs are allocated funding by NHS England to meet local needs and priorities, and improve outcomes. NHS England continues to set national standards, service specifications, and clinical access policies, to which ICBs are expected to apply.We recognise that, in order to ensure the NHS is fit for the future, we must improve care for those with long-term conditions. One of the working groups supporting the development of the 10-Year Health Plan has been asked to develop a vision for how the NHS can evolve to provide responsive, joined-up care to better support individuals with complex health needs who may require frequent, ongoing engagement with the NHS. The group, chaired by Dr Claire Fuller and Caroline Abrahams CBE, will consider what improved care would look like for both individuals living with a single or multiple long-term conditions, including, for example, mental health conditions or disabilities, as well as individuals with multiple complex needs, including those that are frail or approaching the end of their life.We know that appropriate work is generally good for health and wellbeing. We want everyone to get work and get on in work, whoever they are and wherever they live.Disabled people and people with health conditions are a diverse group, so access to the right work and health support, in the right place, at the right time, is key.The Department of Health and Social Care and the Department for Work and Pensions are committed to supporting disabled people and people with health conditions, and have a range of support available so individuals can stay in work and get back into work, including those that join up employment and health systems. Measures include joining up health and employment support around the individual through Employment Advisors in NHS Talking Therapies and Individual Placement and Support in Primary Care, as well as support from Work Coaches and Disability Employment Advisers in Jobcentres and Access to Work grants.As part of the Get Britain Working plan, the Government is launching Keep Britain Working, an independent review into the role of United Kingdom employers in reducing health-related inactivity, and to promote healthy and inclusive workplaces.As ICBs are responsible for commissioning most services for people with long term conditions, most of the data regarding the prevalence of long-term health conditions is collected at the ICB level, although the 10-Year Health Plan will also be focussing on the improved use of data in the health system, as part of the shift from analogue to digital.