Written questions by Dillon.

What steps his Department is taking to support the Pharmacy First campaign.

There is a targeted public communications campaign with associated media materials, running from 11 November 2024 until mid-December 2024 as well as coordinated communications across the healthcare system and sharing best practices where the service is already working well.Action is also being taken to drive further engagement and referrals from general practice, with targeted engagement through regional and integrated care board (ICB) channels and regular data to support managing performance. In addition to this, funding has been provided to ICBs to recruit primary care network engagement leads who will be well placed to support practice teams to refer into the service.Additionally, NHS England is improving digital systems to make the referral process better integrated, including further development of electronic referral systems. Most pharmacies can now also receive Pharmacy First referrals from general practitioners straight into their NHS England assured pharmacy IT systems.

If he will conduct a review of the decision to delegate the power to hold leases for GP premises to integrated care boards.

NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. While we know that is not the most effective use of ICB resources, it is an important safeguard. We are committed to fixing the front door of the NHS by supporting GPs and ICBs through, for example, the £100 million of capital funding announced at the Budget for GP estate upgrades.

What steps his Department is taking to ensure that the clean air policy addresses the risks of (a) carbon monoxide and (b) other indoor air pollutants.

The UK Health Security Agency (UKHSA) works in partnership with other organisations to develop advice and recommended actions which can improve detection of, and prevent accidental exposure to, carbon monoxide in homes. This includes participating in a cross-Government group on gas safety and carbon monoxide awareness, which promotes a joined-up approach to improving gas safety and reducing carbon monoxide poisoning risks.The UKHSA Clean Air Programme includes efforts both to build the evidence base and raise awareness of indoor air quality and its health impacts. Furthermore, the National Institute for Health and Care Excellence has published guidance on indoor air quality at home, designed to raise awareness of the importance of good air quality in people's homes and advise on how to achieve this.Building regulations already require that carbon monoxide alarms are fitted alongside the installation of fixed combustion appliances of any fuel type, excluding gas cookers, in all tenures. The ingress of outdoor air can affect indoor air quality, and the Government is committed to delivering a comprehensive and ambitious Clean Air Strategy.

With reference to paragraph 2.40 of the Autumn Budget 2024, HC 295, published on 30 October 2024, what assessment he has made of the potential impact of the rise in the rate of employer national insurance contributions on pharmacies.

We have taken tough decisions to fix the foundations in the public finances at Autumn Budget. This enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The employer national insurance rise will be implemented April 2025, the Department will set out further details on allocation of funding for next year in due course.

What steps he is taking to ensure that new parents receive adequate support.

The Government has an ambition to achieve the healthiest generation of children ever. A strong child health focus will need to underpin both the Health and Opportunity Missions.The zero- to five-year-olds element of the Healthy Child Programme is a universal, personalised service, led by health visitors and family nurses, for new parents, and reaches 97% of families. Every family should be offered five visits, including antenatal and new birth contact, alongside targeted support for families who require additional help. £3.6 billion was allocated to local authorities through the Public Health Grant in 2024/25, which is used to fund the delivery of the Healthy Child Programme.The Family Hubs and Start for Life Programme provides support for babies and their families in the critical 1,001 days from conception to the age of two. It provides approximately £300 million over three years to 75 local authorities in England with high levels of deprivation to create a network of Family Hubs, with Start for Life services at its core. Support for new parents and carers with babies includes: perinatal mental health support and services, to promote positive early relationships; face-to-face and virtual infant feeding services; and increased capacity for the National Breastfeeding Helpline.The Healthy Start scheme, introduced in 2006, encourages a healthy diet for pregnant women, babies, and young children under four years old from very low-income households.

What steps he is taking with Cabinet colleagues to provide adequate funding for research into blood cancer (a) treatment and (b) care; and what steps he is taking to help tackle delays in blood cancer diagnosis.

The Department funds research into blood cancer through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group.In blood cancer research, the NIHR is funding the £2.6 million PROPEL trial, testing whether a package of enhanced personalised prehabilitation can help people with acute myeloid leukaemia cope better with treatment. The NIHR is also funding a £3 million trial of the drug ibrutinib for treatment of chronic lymphocytic leukaemia, and a £2.2 million study to evaluate the digital health platform, AscelusTM, for management of blood disorders, including cancers.The NIHR welcomes funding applications for research into any aspect of human health, including all cancers. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas. 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.We are committed to improving cancer survival rates and hitting all National Health Service cancer waiting time standards within five years, so no patient waits longer than they should. We will also address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce waits.We are committed to achieving the Faster Diagnosis Standard, which aims to ensure patients have cancer diagnosed or ruled out within 28 days of referral from a general practice (GP) or screening services. We are expanding direct access to diagnostic scans across all GPs, helping to cut waiting times and speeding up a cancer diagnosis or all-clear for patients. The NHS is implementing non-specific symptom pathways for patients who present with vague and non-specific symptoms, which do not clearly align to a cancer type. This aims to reduce the delays experienced by some patients, and are expected to be of particular benefit to people presenting with signs and symptoms that could be due to blood cancer.

What steps he is taking to reduce dermatology waiting times.

Tackling waiting lists is a key part of our Health Mission. We will deliver an extra 40,000 operations, scans, and appointments, including dermatology appointments, each week, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks.We will be supporting National Health Service trusts to deliver these through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.The Government is committed to putting patients first. This means making sure that patients across all specialties, including dermatology, are seen on time, and ensuring that people have the best possible experience during their care.

Whether his Department has made an assessment of the potential impact of waiting times from GP referral to first appointment with dermatology clinic on patients; and what data his Department holds on average such waiting times (a) for NHS Buckinghamshire, Oxfordshire and Berkshire West ICB and (b) nationally.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care, including for dermatology.Whilst no formal assessment has been made of the potential impact of waiting times from general practice (GP) referral to first appointment with a dermatology clinic on patients, dermatology services are being transformed to make sure that patients are seen on time. NHS England’s Getting It Right First Time (GIRFT) programme is working with National Health Service trusts to deliver rapid clinical transformation, with the aim of reducing the numbers of patients waiting more than 52 weeks. The work brings together clinicians and operational teams to work collectively to transform patient pathways, reduce unnecessary appointments, and improve access and waiting times for patients.A clinical transformation group for dermatology was established in summer 2023, focusing on sharing and learning from best practice. Topics for collaboration have included innovative clinic models, for instance super clinics, best practice in the use of technology for telemedicine, best practice in reducing Did Not Attends, reducing unnecessary follow ups through Patient Initiated Follow Up, the role of artificial intelligence, how to develop nurses into advanced roles, and factors to help motivate and retain staff.GIRFT is also planning a programme to support primary care colleagues, offering training for new staff to recognise harmless skin lesions, like moles and warts, with the aim of reducing unnecessary referrals to hospital and freeing up capacity for other patients on the waiting list.Unpublished management information, as of 29 September 2024, from NHS England gives the average wait time for those waiting for first activity on a dermatology pathway of 15.4 weeks for the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board, compared to 13.9 across the whole of England.

If he will make an assessment of the potential merits of taking steps to increase the number of clinical academics dedicated to blood cancer research.

The Department, through the National Institute for Health and Care Research (NIHR), is the largest funder of clinical academic training in the United Kingdom, delivering a comprehensive research career pathway for the full range of clinicians. The NIHR welcomes applications for training awards from the clinical and non-clinical academic workforce conducting research into any aspect of human health, including blood cancer. The NIHR continuously reviews the training offer to identify and address gaps across specialism, geography, and profession, in line with the Department’s priorities.

If he will make funding for the National Breastfeeding Helpline's overnight service permanent.

Breastfeeding has significant benefits for both mothers and babies and it’s important that families are supported to meet their infant feeding goals.The Family Hubs and Start for Life programme has funded the expansion of the National Breastfeeding Helpline, helping families across the country to access virtual breastfeeding support. This includes a pilot of the night-time service from March 2024, ensuring help is available at all times of the day and night, every day of the year.The night service pilot is currently funded to run until the end of March 2025, and we will independently evaluate the pilot to inform future decisions on funding for this service.

What assessment he has made of the potential implications for his policies of NHS England's review entitled General Practice Premises Policy Review, published on 27 June 2019; and whether his Department plans to ensure that leases for GP practices are assigned to NHS bodies.

The GP Premises Policy Review suggested the need to simplify the Premises Costs Directions (PCDs). The PCDs were revised and published on 9 May 2024 and came into force on 10 May 2024. They are available at the following link:https://assets.publishing.service.gov.uk/media/663cd8d2bd01f5ed32793867/nhs_general-medical-services-premises-costs_directions-2024.pdfWhilst NHS England has delegated the power to hold leases to integrated care boards (ICBs), the GP Contract terms ordinarily require the Contractor to hold the premises liability.To bring ICBs into these leasing arrangements would require capitalisation under the International Financial Accounting Standard IFRS16 and limited National Health Service capital budgets would have to be diverted to offset this commitment, in addition to the payment of rents against the properties.ICBs do hold the power to step into such operational leases. A more appropriate way of managing the potential issue is for ICBs to exercise its power to step in to leases only where it is an action of last resort, or by exception, to ensure that vital capital allocations are not adversely affected and continue to be directly invested in primary care estate to provide key improvements and expansion to support patient and service growth.Given where the liabilities lie within contracts and the power held by ICBs to provide exceptional support, NHS England currently only accepts assignment of general practice leases as an action of last resort or by exception.

Whether he has made an assessment of the potential impact of long waiting times for an assessment of neurodevelopmental conditions on children.

The NHS England national framework and operational guidance for autism assessment services, and the National Institute for Health and Care Excellence (NICE) quality standard for autism, set out that diagnostic assessments should happen as soon as possible so that appropriate health, social care, and education interventions, as well as advice and support, can be offered.The Department is currently considering next steps to improve diagnostic assessments and support for autistic people and for people with attention deficit hyperactivity disorder (ADHD).It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism and ADHD services, in line with relevant NICE guidelines. This includes support for children and young people whilst waiting for an assessment.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and what support should follow a recent diagnosis of autism. In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.In respect of ADHD, we are supporting a cross-sector taskforce that NHS England has launched for the challenges in ADHD service provision, to help provide a joined-up approach in response to concerns around rising demand

What steps his Department plans to take to support NHS services in Newbury, in the context of his Department's review of the New Hospital Programme.

The Government recognises that delivering high quality National Health Services requires the right facilities and support systems in the right places. We understand that investment in capital projects, whether through allocations prioritised locally or through national programmes, is important in achieving this.We inherited a New Hospital Programme which was delayed and the funding for which ran out in March. We are reviewing it to provide people in Newbury and across the country with a realistic and costed timetable for delivery. Newbury is served by the Royal Berkshire Hospital scheme which is in scope of the review. The review is feeding into the Spending Review process where the Government will confirm the outcome.Managing the local capital budget for its area and reconfiguring services, which includes addressing estates issues, as well as allocating funds according to local priorities, including investment to support healthcare services, are matters for local NHS organisations. Any future national capital programmes to support NHS organisations delivering local and national priorities will also be considered as part of the Spending Review process.

If he will make an assessment of the implications for his policies of trends in the level of social work vacancy rates in Newbury.

We do not hold information for specific localities, and therefore no assessments have been made. We are committed to the recruitment and retention of social workers, through our existing initiatives like bursaries and the Assessed and Support Year in Employment, which helps build a supply of social workers with the right skills, knowledge, and values.

What steps he plans to take to increase hospice funding.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care, including hospices, will have a big role to play in that shift.Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life and their loved ones.No assessment has been made on the level of variation of hospice funding. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth and range of palliative and end of life care provision within their ICB footprint.