Written questions by Moran.

What steps he is taking to help ensure that Integrated Care Systems provide a range of weight management services.

Local authorities and Integrated Care Boards (ICBs) are responsible for providing local weight management services, taking into account their population needs and relevant guidance. Weight management services range from behavioural programmes to specialist services for those living with obesity and associated co-morbidities.Local authorities are able to fund behavioural weight management services from their Public Health Grant. Additionally, NHS England commissions the NHS Digital Weight Management Programme nationally, which can be accessed via referral from general practice or community pharmacy.ICBs are responsible for commissioning NHS specialist weight management services. Until recently the newest obesity medicines have only been available via the NHS through specialist weight management services. One of these medicines, tirzepatide (brand name Mounjaro®), is now available in primary care, with access currently being prioritised to those with the greatest clinical need. ICBs are developing new care pathways to ensure that patients can access these medicines via general practice.

What steps he is taking to evaluate the effectiveness of NHS weight management programmes.

The Department of Health and Social Care, through the National Institute for Health and Care Research (NIHR), has commissioned a range of research to evaluate the effectiveness of NHS weight management programmes. This includes an evaluation of the NHS Digital Weight Management Programme, which reported in April 2024 and found it to be highly cost-effective service, helping people to lose a clinically meaningful amounts of weight. There is also a £1.7 million evaluation commencing looking at NHS England’s new service models to deliver weight loss drugs outside of hospital settings. It will provide evidence on the effectiveness of the models to support wider roll out. It is expected to report around 2028. In addition, there is a £1.4 million evaluation of NHS England’s Complications of Excess Weight clinics, which deliver tailored support to children and young people with severe or complex forms of obesity. The evaluation will provide evidence on optimal models of care to support future expansion of the clinics and is expected to report around 2026. There is also a range of other ongoing research relevant to weight management services, including looking at services for people with depression and looking at weight regain. The National Institute for Health and Care Excellence has also undertaken an evaluation of digital technologies delivering multidisciplinary weight-management services either with or without prescribing and monitoring obesity medicines. This was published in October 2023 and recommended the technologies that can be used in the NHS while more evidence is generated.

What steps he plans to take to improve the educational provision for health professionals in the (a) diagnosis, (b) prevention and (b) management of chronic pelvic pain in the field of imaging.

The Government is committed to improving the management of long-term conditions, as reflected in our Elective Reform Plan, published in January 2025, and in our 10-Year Health Plan. Part of this will be reforming patient pathways to ensure patients with chronic conditions receive joined-up, rounded care to meet their health needs. NHS England is working with professional clinical bodies on a programme of work to reform pathways, reflecting the required shift of care from hospital to community.Ensuring patients receive their care from skilled healthcare professionals in the right setting is an important part of pathway reform, including for chronic conditions. We will ensure that the number of medical specialty training places, including for radiology and clinical oncology, meets the demands of the National Health Service in the future. Over the next three years, we will create 1,000 new specialty training posts with a focus on specialties where there is the greatest need. The Government is committed to training the staff we need to provide patients with quality and timely care, including health professions. The 10 Year Workforce Plan will outline strategies for improving the training of staff and will work closely with partners in education to do so, to ensure that allied health professional remains an attractive career choice.

What steps he is taking to integrate mental health support into weight management services.

The National Institute for Health and Care Excellence (NICE) produces evidence-based guidance for service commissioners, providers, and health and care practitioners on best practice for weight management. Its guidance on weight management makes a number of recommendations about mental health support. For example, it recommends that:- For adults, providers of weight management services discuss with a person accessing weight management services whether their individual circumstances such as psychological factors may affect their ability to lose weight, and whether referral to another service (such as mental health support) may be appropriate.- For children, practitioners make a referral to the local mental health pathway if there are concerns that the child or young person's mental wellbeing is affected by their weight, that mental health is affecting their weight or the circumstances that influence their weight, or an eating disorder is suspected.- Specialist weight management services, commissioned by NHS integrated care boards, should be provided by multidisciplinary teams, with psychological and behavioural support.More recently, NHS England has issued commissioning guidance for the use of tirzepatide for the management of obesity. It states that prescribers should carefully consider the patient’s overall wellbeing, particularly when eating disorders, body dysmorphia, or mental health status are factors in the request and consideration for treatment. Onward referral to dedicated services may be made where appropriate, in line with local guidelines and existing NICE guidance.

When he expects the NICE guidelines for Dysmenorrhoea, Adenomyosis, and Chronic Pelvic Pain conditions to be published.

The National Institute for Health and Care Excellence (NICE) has no current plans to develop standalone guidelines on dysmenorrhoea, adenomyosis, and chronic pelvic pain.There are existing NICE guidelines on heavy menstrual bleeding, chronic pain, and endometriosis. There is also a Clinical Knowledge Summary on dysmenorrhoea that summarises the current evidence base and provides practical advice for primary care professionals.Topics for new or updated guidance are considered through the NICE prioritisation 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.

What assessment his Department has made of the potential merits of updating the existing regulations on (a) composition, (b) marketing and (c) labelling of commercial infant and toddler foods.

Children’s early years provide an important foundation for their future health and strongly influences many aspects of wellbeing in later life.It is vital that we maintain the highest standards for foods consumed by babies and infants, which is why we have regulations in place that set nutritional and compositional standards for commercial baby food. The regulations also set labelling standards to ensure consumers have clear and accurate information about the products they buy.  We continue to keep these regulations under review to ensure they reflect the latest scientific and dietary guidelines.

What estimate he has made of the potential cost to integrated care boards of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

What estimate he has made of the potential cost to primary care networks of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

What estimate he has made of the potential cost to GPs of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

What estimate he has made of the potential cost to hospitals of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

What estimate he has made of the potential cost to urgent care services of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

What estimate he has made of the potential cost to NHS Trusts of implementing the Equality and Human Rights Commission proposed code of practice for services, public functions and associations, published on 20 May 2025.

To date, no assessment has been made. The Supreme Court’s ruling about the meaning of ‘sex’ in the Equality Acy 2010 case has provided much needed confidence and clarity to service providers.The Equality and Human Rights Commission is currently consulting on the text for an updated statutory code of practice, which will close on 30 June 2025. We will consider any further implications following the outcome.

When he plans to respond to Question 44527, tabled by the hon. Member for Oxford West and Abingdon on 4 April 2025.

I refer the Hon. Member to the answer I gave on 19 May 2025 to Question 44527.

What steps he is taking to increase access to (a) diabetes technologies, (b) insulin pumps and (c) glucose sensors for (i) all diabetes patients and (ii) diabetes patients from deprived backgrounds.

In December 2023, the National Institute for Health and Care Excellence (NICE) published the technology appraisal guidance, Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes, which recommended hybrid closed loop as an option for managing blood glucose levels in type 1 diabetes in children and young people, and specific groups of adults. Hybrid closed loop combines a continuous glucose monitor, an insulin pump, and a computer program to automatically adjust the insulin delivery for people with type 1 diabetes. NHS England also published a five-year Hybrid Closed Loop Implementation Strategy. The rollout of the strategy commenced in April 2024. Further information on the NICE’s technology appraisal guidance is available at the following link: https://www.nice.org.uk/guidance/TA943 Reducing inequity in access to continuous glucose monitors and insulin pumps across the most deprived quintiles and across different ethnic groups is a key objective in NHS England’s Core20PLUS5 health inequalities strategy. DigiBete, a nationally commissioned digital self-management resource for children and young people aged zero to 25 years old, includes information and videos on the latest technology available, with information provided in ten of the most commonly spoken languages. Further information on DigiBete is available at the following link: https://www.digibete.org/type-1-technology-resources/ Data from the National Diabetes Audit suggests that the number of people with type 2 diabetes using continuous glucose monitoring is increasing. In 2022/23, 37,000 people were using a continuous glucose monitor, rising to 95,000 people in 2023/24, and 155,000 people in 2024/25. Metrics that are useful for health systems to monitor access to glucose monitoring will be published later this year.

What steps he is taking to help reduce the risk of young adults developing Type 2 diabetes.

The Department continues to take steps to reduce the risk of type 2 diabetes in young adults through the Healthier You NHS Diabetes Prevention Programme (NHS DPP). The programme supports individuals aged between 18 and 80 years old to reduce their risk of developing type 2 diabetes through lifestyle changes, and has proven highly effective. More than 840,000 people have been supported through the NHS DPP, reducing their risk by 37% compared to those who did not attend.The NHS DPP continues to work in close partnership with Diabetes UK, who raises awareness amongst the public of the symptoms of type 2 diabetes in children, young people, and adults through their website, social media channels, and local campaigns.We are committed to tackling the obstacles driving obesity. We have already laid secondary legislation to restrict advertisements of less healthy food and drink to children on television and online, announced changes to the planning framework for fast food near schools, and we are taking steps to ensure the Soft Drinks Industry Levy remains effective and fit-for-purpose. We are also committed to banning the sale of high-caffeine energy drinks to under 16-year-olds.

What steps he is taking to expand the provision of capital investment for the primary care estate.

The Government is committed to delivering a National Health Service that is fit for the future, by fixing the front door to the NHS and shifting the focus of the NHS out of hospitals and into the community. At the Autumn Budget 2024, we established a dedicated capital fund of £102 million to deliver approximately 200 upgrades to general practice surgeries across England, supporting improved use of existing buildings and space, boosting productivity, and enabling delivery of more appointments. This funding represents a first step in delivering the additional capital the primary care sector needs.The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments, and the Department is currently reviewing capital requirements in line with the Government’s missions and as part of our preparations for Phase 2 of the Spending Review.

If he will provide regular screening for people exposed to Diethylstilbestrol in utero.

The UK National Screening Committee (UK NSC), which advises the Government on screening programmes, has never been asked to consider the evidence for screening people exposed to diethylstilbestrol in utero.Any individual or organisation can submit a topic to the UK NSC to consider a new screening programme via the UK NSC’s annual call, with further information available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal

What assessment he has made of the potential impact of exposure to Diethylstilbestrol on children of women who took that drug while pregnant.

The Medicine and Healthcare products Regulatory Agency continuously assesses the benefit and risk balance of all medicines, at the time of initial licensing and throughout their use in clinical practice, carefully evaluating any emerging evidence on their benefits and risks.In 1971, a US study identified that diethylstilbestrol (DES) could cause a distinct type of cancer in the daughters of women who took DES in early pregnancy. It was subsequently contraindicated in pregnancy, pre-menopausal women, children, and young adults. The issue of DES and vaginal carcinoma in the daughters of women who took DES in pregnancy was reviewed by the predecessor to the Commission on Human Medicines, the Committee on Safety of Medicines (CSM) in the early 1970s. In 1973, the CSM wrote to all doctors to inform them of the results of the US study and the absence of identified cases in the UK.A small increased risk of breast cancer in women who received DES whilst pregnant was first identified in the 1980s and confirmed in further studies in the 1990s, when a longer follow up of women who had taken DES was available. No increased risk of other cancers has been established, including endometrial cancer or ovarian cancer. Since 1992, the National Cancer Institute at the US National Institutes of Health has been conducting the DES Follow-up Study of more than 21,000 mothers, daughters, and sons exposed in the womb during the mother’s pregnancy, to better understand the long-term health effects of exposure to DES. The findings of this follow up have been published in scientific literature. Daughters of individuals exposed to DES are at increased risk of clear cell cancer of the cervix and vagina. The current advice from the UK Health Security Agency, formerly Public Health England, is that routine cervical screening is appropriate for those who believed they were exposed to DES in utero. Further information on the UK Health Security Agency’s advice is available at the following link: https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individuals Participation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.

What steps he is taking to identify people exposed to Diethylstilbestrol.

In 1971, it was identified in a US study that DES could cause a distinct type of cancer in the daughters of women who took DES in early pregnancy. It was subsequently contraindicated in pregnancy, pre-menopausal women, children and young adults. The issue of DES and vaginal carcinoma in the daughters of women who took DES in pregnancy was reviewed by the predecessor to the Commission on Human Medicines, the Committee on Safety of Medicines (CSM) in the early 1970s. In 1973, the CSM wrote to all doctors to inform them of the results of the US study and the absence of cases identified in the UK.Since 1992, the National Cancer Institute (NCI) at the US National Institutes of Health has been conducting the DES Follow-up Study of more than 21,000 mothers, daughters, and sons, exposed in the womb during the mother’s pregnancy, to better understand the long-term health effects of exposure to DES. The findings of this study have been published in the scientific literature.As such, work has been undertaken to contact historic users of DES. Our sympathies are with anyone harmed by its historic use.The UK Health Security Agency advises that routine cervical screening is appropriate for those who believe they were exposed to DES in utero. Further information is available at the following link:https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individualsParticipation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.The MHRA continuously assesses the benefit risk balance of all medicines at the time of initial licensing and throughout their use in clinical practice, carefully evaluating any emerging evidence on their benefits and risks.

What steps he is taking to ensure that NHS Data Security and Protection Toolkit (a) guidance and (b) training is adequate to ensure that NHS staff are compliant with the UK General Data Protection Regulation when working (i) at their place of work and (ii) remotely.

The main source of the UK General Data Protection Regulation (UK GDPR) and information governance (IG) guidance and advice for health and care is the NHS England IG portal, which is available at the following link:https://transform.england.nhs.uk/information-governance/The Data Security and Protection Toolkit (DSPT) includes IG elements to ensure that organisations meet UK GDPR standards. Accompanying DSPT guidance created for small and large health and social care organisations signposts to the IG portal, with further information for both small and large health and social care organisations available, respectively, at the following two links:https://digital.nhs.uk/cyber-and-data-security/guidance-and-assurance/data-security-and-protection-toolkit-assessment-guideshttps://digital.nhs.uk/cyber-and-data-security/guidance-and-assurance/2024-25-caf-aligned-dspt-guidanceThe IG portal guidance is produced on behalf of NHS England, the Department, and key national stakeholders. It is approved by the Information Commissioner’s Office, the United Kingdom’s regulatory authority for data protection, and the National Data Guardian, the independent advisory body for ensuring people’s confidential data is safe.The IG portal provides guidance on a range of topics, including when working remotely, as, for example, it includes guidance on video conferencing and frequently asked questions on accessing information when working from home, with further information on both video conferencing and the frequently asked questions available, respectively, at the following two links:https://transform.england.nhs.uk/information-governance/guidance/using-video-conferencing-and-consultation-tools/https://transform.england.nhs.uk/information-governance/frequently-asked-questions/#covid-19-questions-for-health-and-care-organisationsTo comply with the DSPT training requirements, the vast majority of health organisations use the centrally provided NHS England Data Security Awareness (DSA) course. NHS England reviews the DSA training on an annual basis to ensure that it reflects current best practice for using, sharing, and protecting information.In addition, the Joint Cyber Unit of NHS England and the Department provides online IG training modules, including simple and engaging training for front line staff on information sharing, with further information available at the following link:https://portal.e-lfh.org.uk/Component/Details/750310