Written questions by Anderson.

If he will make an assessment of the potential merits of making pembrolizumab available on the NHS for longer than two years.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based recommendations on whether new licensed medicines should be routinely funded by the National Health Service based on an assessment of clinical and cost effectiveness. The NHS in England is legally required to fund medicines in line with NICE’s recommendations.These are very difficult decisions to make, and it is right that they are taken independently and on the basis of the evidence. NICE’s methods and processes for making its recommendations are internationally respected and have been developed through extensive consultation. NICE is able to recommend the vast majority of new licensed medicines for use on the NHS, and many thousands of patients have benefited from access to medicines as a result.NICE’s guidance on the use of pembrolizumab for the treatment of untreated PD-L1-positive metastatic non-small-cell lung cancer recommends that treatment should be stopped at two years. This recommendation was based on the best available clinical evidence and was made in the interest of patient safety. During the development of guidance, NICE’s appraisal committee was informed by clinical experts that the optimal duration of treatment was unknown and, despite the medicine having low toxicity, long courses of intravenous infusion may be a burden to patients. Further information is set out in paragraph 3.6 of NICE’s published guidance at the following link:https://www.nice.org.uk/guidance/ta531/chapter/3-Committee-discussionThe Department and NHS England do not hold any data on the number of patients who are unable to self-fund treatment of medicines beyond any stopping rule set out in NICE’s guidance.

Whether he is taking steps to ensure anticancer agents can be offered on the NHS for the duration of people’s cancer treatment.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based recommendations on whether new licensed medicines should be routinely funded by the National Health Service based on an assessment of clinical and cost effectiveness. The NHS in England is legally required to fund medicines in line with NICE’s recommendations.These are very difficult decisions to make, and it is right that they are taken independently and on the basis of the evidence. NICE’s methods and processes for making its recommendations are internationally respected and have been developed through extensive consultation. NICE is able to recommend the vast majority of new licensed medicines for use on the NHS, and many thousands of patients have benefited from access to medicines as a result.NICE’s guidance on the use of pembrolizumab for the treatment of untreated PD-L1-positive metastatic non-small-cell lung cancer recommends that treatment should be stopped at two years. This recommendation was based on the best available clinical evidence and was made in the interest of patient safety. During the development of guidance, NICE’s appraisal committee was informed by clinical experts that the optimal duration of treatment was unknown and, despite the medicine having low toxicity, long courses of intravenous infusion may be a burden to patients. Further information is set out in paragraph 3.6 of NICE’s published guidance at the following link:https://www.nice.org.uk/guidance/ta531/chapter/3-Committee-discussionThe Department and NHS England do not hold any data on the number of patients who are unable to self-fund treatment of medicines beyond any stopping rule set out in NICE’s guidance.

What information his Department holds on the number of cancer patients who could not afford to continue using their anticancer agent beyond its NHS availability.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based recommendations on whether new licensed medicines should be routinely funded by the National Health Service based on an assessment of clinical and cost effectiveness. The NHS in England is legally required to fund medicines in line with NICE’s recommendations.These are very difficult decisions to make, and it is right that they are taken independently and on the basis of the evidence. NICE’s methods and processes for making its recommendations are internationally respected and have been developed through extensive consultation. NICE is able to recommend the vast majority of new licensed medicines for use on the NHS, and many thousands of patients have benefited from access to medicines as a result.NICE’s guidance on the use of pembrolizumab for the treatment of untreated PD-L1-positive metastatic non-small-cell lung cancer recommends that treatment should be stopped at two years. This recommendation was based on the best available clinical evidence and was made in the interest of patient safety. During the development of guidance, NICE’s appraisal committee was informed by clinical experts that the optimal duration of treatment was unknown and, despite the medicine having low toxicity, long courses of intravenous infusion may be a burden to patients. Further information is set out in paragraph 3.6 of NICE’s published guidance at the following link:https://www.nice.org.uk/guidance/ta531/chapter/3-Committee-discussionThe Department and NHS England do not hold any data on the number of patients who are unable to self-fund treatment of medicines beyond any stopping rule set out in NICE’s guidance.

What data his Department holds on the cost to the public purse of treatment for people who came to Britain only for (a) health and (b) medical treatment in each of the last three years.

The Department does not collect or hold the information requested.

What data his Department holds on how many people resident outside the UK received medical treatment on the NHS in each of the last three years.

The Department does not collect or hold the information requested.

What steps his Department is taking to help ensure there is adequate mental health support in Ashfield constituency.

NHS Nottingham and Nottinghamshire Integrated Care Board is responsible for commissioning National Health Service mental health services to meet the needs of people in Ashfield.Nationally, the Government is committed to creating an environment that promotes good mental health, prevents people from developing mental health problems, and improves the lives of people living with a mental health problem including those in the Ashfield constituency.The 10-Year Health Plan sets out ambitious plans to transform mental health services to improve access and treatment, and to promote good mental health and wellbeing for the nation. This includes improving assertive outreach, investing in mental health emergency departments and neighbourhood mental health centres, and increasing access to talking therapies and evidence-based digital interventions.The recently published Medium Term Planning Framework sets targets for integrated care boards to expand coverage of mental health support teams in schools and colleges, expand NHS Talking Therapies and Individual Placement Support schemes, and eliminate inappropriate out-of-area placements by 2029.

What steps his Department is taking to help ensure veterans receive appropriate support for PTSD.

In addition to the mainstream mental health services commissioned by integrated care boards, NHS England commissions Op COURAGE which is the bespoke integrated veterans’ mental health and wellbeing service. The service provides a fully integrated mental health care pathway for veterans, which includes support for veterans with post-traumatic stress disorder. People benefit from personalised care plans, ensuring they can access support and treatment both in and out of hours. Op COURAGE is available across England and individuals can contact the service to make an appointment or ask someone to do this on their behalf.The Government recognises that not all veterans want to use veteran-specific mental health services and can instead choose to use mainstream services in the National Health Service, such as talking therapies, which are available to both veterans and civilians.

How many deaf individuals have been wrongly assessed under the Mental Capacity Act 2005 as a result of communication barriers in the last 12 months.

The Department does not hold the requested data.

What steps he is taking to help improve the (a) autonomy and (b) wellbeing of deaf residents in care homes.

Local authorities are best placed to understand and plan for the needs of their population. That is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people have a choice of appropriate services that put the wellbeing of the people who draw on care at the centre of decisions.Under the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. Since 2016, all National Health Service organisations and publicly funded social care providers are also expected to meet the Accessible Information Standard, which details the approach to supporting the information and communication support needs of people with a disability, impairment, or sensory loss.

What steps he is taking to ensure that British Sign Language services are provided in care homes in England.

Local authorities are best placed to understand and plan for the needs of their population. That is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people have a choice of appropriate services that put the wellbeing of the people who draw on care at the centre of decisions.Under the Equality Act 2010, health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. Since 2016, all National Health Service organisations and publicly funded social care providers are also expected to meet the Accessible Information Standard, which details the approach to supporting the information and communication support needs of people with a disability, impairment, or sensory loss.

What steps he is taking to help ensure that deaf people are not wrongly identified as lacking mental capacity due to communication barriers.

The Mental Capacity Act (MCA) 2005 already provides a legislative basis for providing interpreters, including British Sign Language interpreters, for people with specific communication needs. One of the foundational principles of the MCA is that individuals must be given all possible support to make, or participate in making, their own decisions. This includes taking "all practicable steps" to help them understand, weigh up information, and communicate their choice. Section 3.11 of the MCA Code of Practice provides detailed guidance on this.My Rt Hon. Friend, the Secretary of State for Health and Social Care will also launch a joint consultation with the Ministry of Justice on the Liberty Protection Safeguards in the first half of next year. This consultation will seek the views of those affected, including members of the deaf community and experts who work with deaf individuals. The responses from this consultation will be used to inform a final MCA Code of Practice which will be laid in Parliament.

If he will take legislative steps to ensure that BSL interpreters are provided during mental capacity assessments.

The Mental Capacity Act (MCA) 2005 already provides a legislative basis for providing interpreters, including British Sign Language interpreters, for people with specific communication needs. One of the foundational principles of the MCA is that individuals must be given all possible support to make, or participate in making, their own decisions. This includes taking "all practicable steps" to help them understand, weigh up information, and communicate their choice. Section 3.11 of the MCA Code of Practice provides detailed guidance on this.My Rt Hon. Friend, the Secretary of State for Health and Social Care will also launch a joint consultation with the Ministry of Justice on the Liberty Protection Safeguards in the first half of next year. This consultation will seek the views of those affected, including members of the deaf community and experts who work with deaf individuals. The responses from this consultation will be used to inform a final MCA Code of Practice which will be laid in Parliament.

What assessment he has made of the adequacy of (a) staff training on support for and (b) support available to deaf residents in care homes.

The Government is taking steps to improve the quality of adult social care, which will include deaf people in care homes.The Department is committed to enhancing the skills of staff working in adult social care. To this end, the Department launched the Adult Social Care Learning and Development Support Scheme in September 2024, providing funding for eligible care staff to complete training courses and qualifications. In April 2025, the Department also published the expanded and revised Care Workforce Pathway. The pathway guides workers in building their careers in adult social care by signposting training and development opportunities, highlighting routes for progression, and giving proper recognition to the highly skilled, complex care and support they provide.The Care Quality Commission (CQC) is assessing how well local authorities in England are performing against their duties under the Care Act 2014, including their duties relating to the access and provision of care and support for deaf people. The CQC also monitors, inspects, and regulates adult social care services to make sure they meet fundamental standards of quality and safety. For deaf individuals, this includes providing care that is responsive to their communication needs.

Whether their Department has run any (a) recruitment and (b) internship schemes aimed to increase the number of people from underrepresented groups in the workforce in the last year.

The Department has not run any recruitment with the sole aim of increasing the number of people from underrepresented groups in the workforce in the last year.The Department has not run any internship schemes but has participated in the following internship schemes, to deliver greater diversity in the Civil Service and make it more representative of the people it serves, in the past 12 months:the Care Leavers Internship Programme, ran by the Department for Education, which offers cave-experienced people between the ages of 18 and 30 years old a placement in Government departments, supporting the Government’s commitment to social mobility;the Summer Internship Programme, ran by the Cabinet Office, which offers candidates from lower socio-economic backgrounds a temporary placement in Government departments to provide an opportunity to experience what it feels like to work in the Civil Service; andthe Autism Exchange Internship Programme, ran by the Cabinet Office, which offers summer internships to autistic young people and aims to provide valuable work experience and skills to participants, while also helping Government departments better understand and support autistic employees.

What steps his Department is taking with (a) local authorities and (b) voluntary organisations to assist disabled people with transportation to medical appointments.

As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from referral to treatment by March 2029, a standard which has not been met consistently since September 2015. The Government is clear that reforming elective care must be done equitably and inclusively for all adults, children, and young people. We know there is also geographical variation in waiting times. It is important that patients, including disabled patients, do not miss or cancel hospital appointments due to a lack of affordable and/or accessible transport options in their area. This is why the Elective Reform Plan, published in January 2025, committed to reviewing, developing and increasing the uptake of existing national health inequalities improvement initiatives. Specifically, the plan committed to reviewing local patient transport services and improving the signposting to, and the accessibility of, them for patients, to make it easier for vulnerable groups to travel to and access appointments. NHS England are funding and co-ordinating a range of patient transport projects to explore more effective approaches to supporting patients with their NHS travel needs.NHS England work with individual NHS organisations, local authorities, transport providers and other stakeholders to continually pilot, review, refine and propagate approaches to improving the choice, affordability, and accessibility of transport options for NHS patients. A non-emergency patient transport service (NEPTS) provides funded transport where a medical condition means a patient cannot safely travel to receive their treatment independently. Transport may be provided by the ambulance service, independent providers, the voluntary sector and volunteers.

What steps he is taking to improve the quality of (a) care and (b) support for deaf people in care homes.

The Government is taking steps to improve the quality of adult social care, which will include deaf people in care homes. This includes improvements to better support the vital care workforce through a Fair Pay Agreement backed by £500 million, expanded career pathways, and £12 million invested in training and qualifications.We have also launched an independent commission, chaired by Baroness Casey, to help shape the future of adult social care and ensure it meets the needs of older people and working-age disabled adults. The commission will explore how to improve accountability and drive up quality across the system.Under section 18 of the Care Act 2014, local authorities are required to meet the needs of adults in their area who meet the eligibility criteria, which would include deaf people that have eligible needs. In addition, under the Equality Act 2010, local authorities must make reasonable adjustments to ensure that disabled people are not disadvantaged.The Care Quality Commission (CQC) are assessing how well local authorities in England are performing against their duties under part one of the Care Act 2014, including their duties relating to the access and provision of care and support for deaf people. Support for deaf people forms part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will report on access and provision of care and support for deaf people when there is something important to highlight, such as something being done well, innovative practice or an area for improvement.The CQC monitors, inspects and regulates adult social care services to make sure they meet fundamental standards of quality and safety. For deaf individuals, this includes providing care that is responsive to their communication needs.

What steps he is taking to help ensure that deaf people can receive appropriate care at home.

Local authorities are best placed to understand and plan for the needs of their populations, which is why, under the Care Act 2014, local authorities are tasked with the duty to shape their care market to meet the diverse needs of all people, including ensuring that deaf people receive appropriate care at home.Additionally, the Government is taking steps to ensure that people, including deaf people, can receive high-quality, personalised care at home. This is part of the Government’s wider improvements to adult social care as we progress towards a National Care Service. These steps include:- investing £12 million in workforce training through the Learning and Development Support Scheme, helping care workers to develop the skills needed to support people with sensory disabilities, including deaf individuals;- rolling out the Care Workforce Pathway, which sets out the knowledge, skills and behaviours needed to deliver high-quality care across eight role categories, including personal assistants and enhanced care workers;- supporting unpaid carers, who play a vital role in home-based care – from March 2026, millions of unpaid carers will be able to manage care plans, appointments and prescriptions via the NHS App;- raising the Carer’s Allowance earnings limit to £196 per week and reviewing the case for paid carer’s leave;- expanding care options to support independent living, with an additional £172 million for the Disabled Facilities Grant over two years, enabling around 15,600 extra home adaptations; and- introducing care technology standards to help people choose the right support at home.

What steps he is taking to help reduce incidences of the misdiagnosis of patients with postural orthostatic tachycardia syndrome.

Postural tachycardia syndrome (PoTS) is diagnosed by a combination of general practitioners (GPs) and specialist clinicians. GPs can diagnose PoTS in many cases but, if they are unsure of symptoms, or if symptoms are complex, they will refer patients to specialists for diagnosis.We are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment, by March 2029.Additionally, the shifts outlined in our 10-Year Health Plan will free up hospital-based consultants’ time by shifting care from hospitals to communities, utilising digital technology to reduce administrative burdens, and promoting prevention to reduce the onset and severity of conditions that lead to hospital admissions. This includes expanding community-based services, employing artificial intelligence for productivity, developing integrated neighbourhood health teams, and investing in digital tools and data. These shifts will allow specialists to focus on more complex cases of PoTS, enabling earlier identification and management, and improved patient outcomes.By shifting care into the community through Neighbourhood Health Services, promoting integrated, multidisciplinary models of care and expanding personalised care plans, as outlined in the 10-Year Health Plan, we will ensure that people with conditions like PoTS receive more timely and accessible support closer to home.As part of their continuing professional development, medical staff are responsible for updating their clinical knowledge with new research and guidance, ensuring they can accurately recognise and treat conditions such as PoTS.The National Institute for Care Excellence has published a clinical knowledge summary on blackouts and syncope, which details how clinicians should assess and diagnose PoTS. Additionally, the Syncope Toolkit, developed by the Royal College of General Practitioners, is a resource designed to help GPs manage patients with syncope and related disorders, including PoTS.

What steps his Department is taking to (a) support research into and (b) improve healthcare for young people with Ehlers Danlos Syndrome.

A primary goal of the Complex Ehlers-Danlos Syndrome (EDS) Service, which is commissioned by NHS England, is to educate clinicians about the diagnosis, investigation, and management of patients with complex and atypical forms of EDS. While the service focuses on rare condition types and accepts referrals from secondary and tertiary care, its development of guidelines and educational initiatives also benefits general practitioners (GPs), who are on the front line of patient care. Additionally, other resources like the EDS GP Toolkit, developed by the Royal College of General Practitioners and Ehlers-Danlos Support UK, is specifically designed to provide information and guidance to GPs.Integrated care boards (ICBs) have a statutory responsibility to commission services which meet the needs of their local population, including for those with EDS. It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop services and care pathways that meet patients’ needs.EDS is diagnosed by a combination of GPs, specialist clinicians, and the national diagnostic service for rare types. GPs can diagnose common types like hypermobility EDS and may refer to a specialist if needed. We are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard, that 92% of patients to wait no longer than 18 weeks from referral to treatment, by March 2029.Additionally, the shifts outlined in our 10-Year Health Plan will free up hospital-based consultants’ time by shifting care from hospitals to communities, utilising digital technology to reduce administrative burdens, and promoting prevention to reduce the onset and severity of conditions that lead to hospital admissions. This includes expanding community-based services, employing artificial intelligence for productivity, developing integrated neighbourhood health teams, and investing in digital tools and data. These shifts will allow specialists to focus on more complex cases of EDS, enabling earlier identification and management, and improved patient outcomes.The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). The NIHR welcomes funding applications for research into any aspect of human health and care, including EDS and any related conditions. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

What steps he is taking to improve access to (a) effective and (b) timely healthcare support for people with postural orthostatic tachycardia syndrome.

Postural tachycardia syndrome (PoTS) is diagnosed by a combination of general practitioners (GPs) and specialist clinicians. GPs can diagnose PoTS in many cases but, if they are unsure of symptoms, or if symptoms are complex, they will refer patients to specialists for diagnosis.We are investing in additional capacity to deliver appointments to help bring waiting lists and times down. The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment, by March 2029.Additionally, the shifts outlined in our 10-Year Health Plan will free up hospital-based consultants’ time by shifting care from hospitals to communities, utilising digital technology to reduce administrative burdens, and promoting prevention to reduce the onset and severity of conditions that lead to hospital admissions. This includes expanding community-based services, employing artificial intelligence for productivity, developing integrated neighbourhood health teams, and investing in digital tools and data. These shifts will allow specialists to focus on more complex cases of PoTS, enabling earlier identification and management, and improved patient outcomes.By shifting care into the community through Neighbourhood Health Services, promoting integrated, multidisciplinary models of care and expanding personalised care plans, as outlined in the 10-Year Health Plan, we will ensure that people with conditions like PoTS receive more timely and accessible support closer to home.As part of their continuing professional development, medical staff are responsible for updating their clinical knowledge with new research and guidance, ensuring they can accurately recognise and treat conditions such as PoTS.The National Institute for Care Excellence has published a clinical knowledge summary on blackouts and syncope, which details how clinicians should assess and diagnose PoTS. Additionally, the Syncope Toolkit, developed by the Royal College of General Practitioners, is a resource designed to help GPs manage patients with syncope and related disorders, including PoTS.