Written questions by Anderson.

What assessment his Department has made of the potential impact of levels of capacity in phlebotomy services on the time taken for leukaemia cases to be diagnosed.

We are taking meaningful steps to improve cancer diagnostic performance for all cancers, including leukaemia. The 2025/26 NHS Planning Guidance sets a stretching target for cancer diagnosis that will see approximately 100,000 more people every year having cancer confirmed or ruled out within 28 days.This will be supported by our commitment to improve diagnostic performance. We are delivering an additional two million operations, scans, and appointments during our first year in Government, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks. As of December 2024, community diagnostic centres are now delivering additional tests and checks on 168 sites across the country and have delivered over 12.2 million additional tests since July 2021, including phlebotomy service tests.We have also announced plans for a revised NHS Long Term Workforce Plan in summer 2025 to ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.Finally, the National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology. The plan will seek to improve every aspect of cancer care to improve the experience and outcomes for people with cancer, including leukaemia.

What steps his Department is taking to (a) help support community pharmacists in the early detection of leukaemia, (b) expand phlebotomy capacity and (c) increase levels of access to full blood counts.

It is a priority for the Government to support the National Health Service in catching cancer, including blood cancers, as early as possible, to treat these diseases faster and more effectively, and thereby improve outcomes.NHS England does not currently commission any phlebotomy or full blood count services from community pharmacies. Patients can access these services in community diagnostic centres (CDCs), which offer local populations a wide range of diagnostic tests closer to home, and greater choice on where and how they are undertaken, reducing the need for hospital visits and speeding up diagnosis.The Elective Reform Plan commits to transform and expand diagnostic services and speed up waiting times for tests, including for blood tests. We will also expand the number of CDCs operating seven days a week and 12 hours a day, as well as the tests they offer, so that patients have greater access to these more convenient tests. We will also deliver additional CDC capacity in 2025/26 by expanding a number of existing CDCs and building up to five new ones.

What steps he is taking to improve access to (a) healthcare services, (b) GPs and (c) mental health support in (i) Ashfield and (ii) Mansfield constituencies.

Since June 2022, the 42 integrated care boards (ICBs) across England have been responsible for arranging National Health Service healthcare services that meet the clinical needs of their respective populations, with the NHS Nottingham and Nottinghamshire ICB being responsible the Ashfield and Mansfield constituencies.However, we know that patients are struggling to see a general practitioner (GP) and we are committed to improving access to GP appointments across the country, including in the Ashfield and Mansfield constituencies. That’s why, in October 2024, we provided an £82 million boost to the Additional Roles Reimbursement Scheme, enabling the recruitment of 1,000 newly qualified GPs across England. This will increase the number of GPs employed and the number of appointments delivered in GPs, benefitting thousands of patients that are struggling to receive the care they desperately deserve. Additionally, we have announced a proposed £889 million uplift to the GP Contract for 2025/26, the largest uplift in years, with a rising share of total NHS resources going to GPs. We are currently consulting the profession on key proposals to improve access, continuity of care, and GP recruitment.We recognise that many people in the Ashfield and Mansfield constituencies are not getting the mental health support or care they need. As part of our mission to build an NHS that is fit for the future and that is there when people need it, the Government will recruit an additional 8,500 mental health workers nationally to reduce wait times and provide faster treatment. We will also provide access to a specialist mental health professional in every school in England, roll out Young Futures hubs in every community, and modernise the Mental Health Act.

What steps his Department is taking to help ensure that (a) Sativex and (b) other medications for MS patients are (i) affordable and (ii) funded in (A) Nottinghamshire and (B) other areas.

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.The NICE has been able to recommend several medicines for the treatment of multiple sclerosis, including ublituximab, which has recently been recommended for treating relapsing multiple sclerosis in guidance published on 18 December 2024. The NHS in England is legally required to fund medicines recommended in a NICE appraisal, usually within three months of final guidance.The NICE guideline on cannabis-based medicinal products recommends that Sativex, a licensed cannabis-based product, should be offered for the treatment of moderate to severe spasticity in adults with multiple sclerosis, if other pharmacological treatments for spasticity are not effective. As Sativex has not been evaluated through the NICE’s technology appraisal programme, it is not subject to a funding requirement. Therefore, the decision on whether to prescribe must be taken by a specialist clinician on a case-by-case basis, and funding of this medicine is subject to local National Health Service decisions. On 6 September 2021, NHS England issued a reminder to NHS trusts and commissioners, now integrated care boards, of the NICE’s guidance relating to Sativex, and their responsibilities. This resulted in an increase in the prescribing of this drug, and NHS England is monitoring uptake of prescribing, in-line with the NICE’s recommendations.

What steps his Department is taking to increase the availability of mental health support for men under 50.

The Government accepts that too many men are not getting the support with their mental health that they deserve. As part of our mission to build a National Health Service that is fit for the future, we will recruit an additional 8,500 mental health workers to reduce delays and provide faster treatment, which will also help ease pressure on the busy mental health services.We are also committed to tackling suicide as one of the biggest killers of men. The 8,500 new staff will be specially trained to support people at risk from suicide.The five-year Suicide Prevention Strategy for England, published in September 2023, identifies young people and middle-aged men as one of a number of groups for consideration for tailored or targeted action at a national level.Many voluntary community and social enterprise organisations are also working hard to ensure that men have access to different types of services for a range of needs and preferences, in places where they are most likely to engage.

What steps his Department is taking to ensure that 92% of NHS patients are treated within 18 weeks.

Tackling waiting lists is a key part of our Health Mission. The NHS Constitutional Standard for 92% of patients to wait no longer than 18 weeks from Referral to Treatment has not been met consistently since September 2015, and is a priority for the Government. As a first step, we will deliver an extra 2 million operations, scans, and appointments per year, which is equivalent to 40,000 a week, during our first year in Government.A plan will be published in the coming weeks, which will set out more detail on how the National Health Service will deliver on the 18-week standard.

If he will make an assessment of the potential merits of (a) reimbursement schemes and (b) financial assistance programmes for patients seeking private dental care because of NHS delays.

The National Health Service contracts with independent dental providers to deliver NHS dental treatment. Dentists must make clear which treatments can be provided on the NHS and which can only be provided on a private basis, and the costs associated for each. If a patient decides to choose alternative private options, this should be included in their treatment plan.

What plans his Department has to tackle funding gaps between (a) mental and (b) physical health services.

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 we give mental health the same attention and focus as physical health, and that people can be confident in accessing high quality mental health support when they need it. My Rt Hon. Friend, the Secretary of State for Health and Social Care will set out expectations for mental health funding, including its share of overall National Health Service expenditure in 2025/26, in due course, as required under section 3(2) of the Health and Care Act 2022.

What plans his Department has to improve dementia care services in Ashfield and Mansfield constituency.

Key priorities for Nottingham and Nottinghamshire Integrated Care Board (ICB) are to deliver the national target of a dementia diagnosis rate of 66.7%, reduce waiting to time for memory assessment services and to improve access to post-diagnostic support. A Dementia strategy for Nottingham and Nottinghamshire will be updated following the Government’s publication of the 10-Year Health Plan expected in spring 2025.Ongoing dementia care services include a Dementia Wellbeing Service provided by Alzheimer’s Society, across Nottingham and Nottinghamshire, including Mansfield and Ashfield. The service aims to support patients and carers through several interventions including cognitive stimulation therapy, carer training, 1:1 and group support.The two Ashfield Primary Care Networks (PCN), North & South, piloted an Admiral Nurse within general practices. An Admiral Nurse is a specialist Dementia Nurse supporting patients and carers to live well with Dementia. Following a successful pilot, Ashfield North Primary Care Network have chosen to retain the role to support patients and carers within the network’s practices. Rosewood PCN in Mansfield has recruited a dementia specialist Occupation Therapist to support patients and carers living with dementia within their network of practice.

Which locations in Ashfield are currently providing the Pfizer covid-19 vaccine for people who are unable to have the Modena vaccine for health reasons.

The Government is guided by the advice of the independent Joint Committee on Vaccination and Immunisation (JCVI) for its immunisation and vaccination programmes. This includes eligibility for vaccination and the vaccines that may be used in the national programme.Both the Moderna mRNA (Spikevax) COVID-19 vaccine and the Pfizer-BioNTech mRNA (Comirnaty) COVID-19 vaccine are approved for use in the United Kingdom and, in line with JCVI advice, may be used in the autumn 2024 COVID-19 national vaccination programme. NHS England advises that all sites in Ashfield are currently providing the Moderna vaccine, and that from November 2024 the Pfizer vaccine is also expected to be supplied. The vaccine or vaccines being supplied at individual sites or nationally is, within JCVI guidance, an operational matter. Further information on the JCVI’s advice is available at the following link:https://www.gov.uk/government/publications/covid-19-autumn-2024-vaccination-programme-jcvi-advice-8-april-2024/Guidance from the UK Health Security Agency (UKHSA) states that there are very few individuals who cannot receive the COVID-19 vaccines approved in the UK. Anyone concerned about possible reactions to a vaccine should in the first instance speak to the clinician responsible for their care for advice.Published UKHSA clinical guidance for health professionals and immunisation practitioners on COVID-19 vaccination includes guidance for the management of patients with a history of allergy, including circumstances where a person may be referred to an expert allergist and, after a review of the individual’s risks and benefits of vaccination, where it is indicated, they could then be vaccinated in hospital under clinical supervision. NHS England will continue to follow this clinical guidance.

What steps his Department plans to take to ensure that men at risk of prostate cancer can access the PSA blood test.

Currently, men who have symptoms that could be associated with prostate cancer may be offered the Prostate Specific Antigen (PSA) test, which looks at levels of PSA in the blood, in line with National Institute for Health and Care Excellence cancer recognition and referral guidance.However, due to the levels of inaccuracy, the PSA test is not recommended as a screening tool for healthy men with no symptoms. This is because high level of inaccuracy could lead to unnecessary tests and treatments that carry risks of life-changing harm, such as urinary and faecal incontinence, and sexual dysfunction, as well as a smaller but serious risk of sepsis. Additionally, some prostate cancers may not produce elevated PSA levels, leading to false-negative results that provide deceptive reassurance.Instead, men should be encouraged to know the symptoms of prostate cancer and look out for changes in their body, and should seek advice from a general practitioner if these changes occur.

What steps his Department plans to take to increase the number of healthcare professionals in rural areas.

The recent annual reports from the Chief Medical Officer for England set out the clear healthcare challenges patients face when living in remote, rural, and coastal areas.It is clear that the National Health Service has faced chronic workforce shortages across all communities for years, and fixing this will take time. We have commissioned the 10-Year Health Plan, and a central and core part of this will be our workforce, and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.Plans and policies will align with the strategic objectives set out in the 10-Year Health Plan, and will support its delivery.

Whether he plans to increase funding for NHS smoking cessation programmes for pregnant women.

The Government is funding a broad package of measures to tackle the harm caused by smoking, including launching the National Smoke-free Pregnancy Incentives Scheme. The scheme can recruit pregnant smokers until 31 March 2025, who will be eligible to receive incentives until three months post-partum for becoming and remaining smoke-free, subject to confirmation via a carbon monoxide breath test. All decisions on funding beyond March 2025 remain subject to the Spending Review process.

How much (a) funding and (b) other resources his Department is providing to GP practices to help meet the demand for appointments in the (a) 2024-25 and (b) 2025-26 financial year.

We hugely value the critical role that general practitioners (GPs) play, and we are determined to address the issues they face by shifting the focus of the National Health Service beyond hospitals and into the community. GPs and primary care have been receiving a smaller proportion of NHS resources over time, and we’re committed to reversing that.On 28 February 2024, NHS England published details of the changes to the GP contract for 2024/25, including an overall increase in funding of £259 million, taking overall contract investment to £11,864 million in 2024/25. The 2024/25 contract at that point included a 2% planning assumption for pay, which was used to uplift the GP contract from 1 April 2024. We turned to the independent pay review body, the Doctors' and Dentists' Remuneration Board (DDRB), for a recommendation on pay for 2024/25.We have accepted the DDRB’s recommendations in full and, following consultation with the British Medical Association, we uplifted the pay element of the GP contract by 6% on a consolidated basis, an increase of 4% on top of the 2% interim uplift in April, to provide practices with funding to uplift GP partners, salaried GPs, and other salaried staff pay by 6%. The global sum element of the contract has been increased by 7.4% to fund the 6% increase in pay.Departmental expenditure limits for 2025/26 will be set alongside the Budget in October. The overall GP contract investment in 2025/26 will be determined afterwards.

Whether he plans to increase the number of NHS staff working on maternity units.

We are committed to growing workforce capacity as quickly as possible to meet local needs and achieve safe staffing levels. Bringing in the staff we need will take time, but this is an absolute priority for the Government. We have launched a 10-Year Health Plan to reform the National Health Service and make it fit for the future.One of the themes in NHS England’s Three-Year Delivery Plan covers growing, retaining, and supporting our workforce. NHS England is boosting the midwifery workforce through undergraduate training, apprenticeships, postgraduate conversion, return to midwifery programmes, and international recruitment.We also remain committed to the Long-Term Workforce Plan, which sets out the steps the NHS and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years. It will put the workforce on a sustainable footing for the long term.

What estimate he has made of the cost of (a) Wegovy and (b) Mounjaro to tackle obesity.

Wegovy is recommended for National Health Service use within a specialist weight management service. It launched in the United Kingdom in September 2023. The price for Wegovy is subject to a confidential commercial agreement between Novo Nordisk and NHS England.Mounjaro is not yet recommended for the management of obesity in the NHS. However, it is under assessment by the National Institute for Health and Care Excellence. Their recommendation is currently due to be published in December 2024. The current list price for the maximum dosage of Mounjaro is £122 for a month’s supply. The maximum annual price of Mounjaro per patient is therefore £1,464 based on 12 months at maximum dosage. This does not include service delivery costs to the NHS.

How long patients will be able to use (a) Wegovy and (b) Mounjaro on the NHS; and how long they can safely be used for.

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, and for providing guidance for the health and care system on best practice.The NICE has published guidance on semaglutide (Wegovy) for managing overweight and obesity. It states that it should be used for a maximum of two years. Re-prescribing Wegovy would be at the discretion of local systems following an additional referral. Integrated care boards are responsible for arranging the provision of health services within their area in line with local priorities, considering population need, and taking account of relevant guidance. This includes the commissioning of NHS specialist weight management services.The NICE has not yet published final guidance on the use of tirzepatide (Mounjaro) for managing overweight and obesity. In its draft guidance, there is no mandatory stopping time, but the NICE does recommend that treatment cessation should be considered if less than 5% of the initial weight has been lost after six months.Neither Wegovy nor Mounjaro has time limits on their use in their Summary of Products Characteristics documents, which describe the properties and the officially approved conditions of use of a medicine. Information is continuously collected after a medicine is placed on the market, to monitor real-life experience with the product. The Medicine and Healthcare products Regulatory Agency closely monitors this information, to make sure that the benefits of the medicine continue to outweigh the risks. Both Wegovy and Mounjaro contain new active substances and are subject to additional monitoring through the Black Triangle Scheme, though this does not mean that they are unsafe.

Whether patients can be re-administered weight loss medication on the NHS if they regain weight following treatment.

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, and for providing guidance for the health and care system on best practice.The NICE has published guidance on semaglutide (Wegovy) for managing overweight and obesity. It states that it should be used for a maximum of two years. Re-prescribing Wegovy would be at the discretion of local systems following an additional referral. Integrated care boards are responsible for arranging the provision of health services within their area in line with local priorities, considering population need, and taking account of relevant guidance. This includes the commissioning of NHS specialist weight management services.The NICE has not yet published final guidance on the use of tirzepatide (Mounjaro) for managing overweight and obesity. In its draft guidance, there is no mandatory stopping time, but the NICE does recommend that treatment cessation should be considered if less than 5% of the initial weight has been lost after six months.Neither Wegovy nor Mounjaro has time limits on their use in their Summary of Products Characteristics documents, which describe the properties and the officially approved conditions of use of a medicine. Information is continuously collected after a medicine is placed on the market, to monitor real-life experience with the product. The Medicine and Healthcare products Regulatory Agency closely monitors this information, to make sure that the benefits of the medicine continue to outweigh the risks. Both Wegovy and Mounjaro contain new active substances and are subject to additional monitoring through the Black Triangle Scheme, though this does not mean that they are unsafe.

With reference to his Department's press release entitled Landmark collaboration with largest pharmaceutical company, published on 14 October 2024, how many times will a patient be allowed to take a course of Mounjaro, in the context of the five year trial in Greater Manchester.

As announced on 14 October 2024, the SURMOUNT-REAL clinical trial of tirzepatide, brand name Mounjaro, is being developed between Health Innovation Manchester, The University of Manchester, and Eli Lilly and Company, with further details about the study to be published at a later date by these organisations, following on from relevant approvals.

Whether he plans to take steps to increase funding for pharmacies.

Pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists, as we shift care from hospitals to the community.The consultation with Community Pharmacy England on the national funding and contractual framework arrangements for 2024/25 has not yet been concluded, and we are looking into this as a matter of urgency.Pharmacies are private businesses and decisions to close reflect many factors. Patient access to pharmaceutical services remains good in England, with four in five people living within a 20-minute walk from a pharmacy, and twice as many pharmacies in the most deprived areas. Patients can also access approximately 400 Distance Selling Pharmacies, who must operate nationally and send medicines to patients’ home free of charge, and in rural areas, Dispensing Doctors can supply medicines.