Written questions by Smart.

What discussions his Department has had with NHS England and relevant Integrated Care Boards on the funding of specialist orthotist posts required to deliver vacuum bell therapy at NHS pectus and chest wall surgical centres; and whether he has made an assessment of the potential impact on patient care of surgical services being available but non-surgical alternatives being unavailable.

The factors that determine whether a service is a prescribed specialised service are: the number of individuals who require the service; the cost of providing the service or facility; and the number of people able to provide the service or facility.Vacuum bell therapy for pectus excavatum is not designated as a prescribed specialised service. Non surgical management of pectus excavatum is considered a pathway based intervention better managed through local medical pathways. Responsibility for commissioning therefore sits with integrated care boards (ICBs) rather than NHS England or the Department. There are no current plans to change this approach.NHS England will continue to encourage ICBs to prioritise commissioning non surgical medical treatments for patients with pectus excavatum as part of an integrated pathway. In addition, through the National Institute for Health and Care Research, the Department is funding the RESTORE trial, which will inform future commissioning decisions in relation to surgery. More information on the RESTORE trial is available at the following link:https://www.fundingawards.nihr.ac.uk/award/NIHR158749

For what reason NHS England has designated vacuum bell therapy for pectus excavatum as the responsibility of Integrated Care Boards rather than including it within the specialised commissioning arrangements that cover surgical correction of pectus excavatum; and whether his Department plans to review that designation.

The factors that determine whether a service is a prescribed specialised service are: the number of individuals who require the service; the cost of providing the service or facility; and the number of people able to provide the service or facility.Vacuum bell therapy for pectus excavatum is not designated as a prescribed specialised service. Non surgical management of pectus excavatum is considered a pathway based intervention better managed through local medical pathways. Responsibility for commissioning therefore sits with integrated care boards (ICBs) rather than NHS England or the Department. There are no current plans to change this approach.NHS England will continue to encourage ICBs to prioritise commissioning non surgical medical treatments for patients with pectus excavatum as part of an integrated pathway. In addition, through the National Institute for Health and Care Research, the Department is funding the RESTORE trial, which will inform future commissioning decisions in relation to surgery. More information on the RESTORE trial is available at the following link:https://www.fundingawards.nihr.ac.uk/award/NIHR158749

What steps his Department is taking to help support shops, small businesses and public buildings to host publicly accessible defibrillators.

The Government’s position is that local communities are best placed to make decisions about procuring, locating, and maintaining automated external defibrillators (AEDs). Over 110,000 defibrillators are registered in the United Kingdom on The Circuit, the independent AED database. Over 30,000 of these were added between September 2023 and July 20225, many as a result of local community led action.

What the planned timeline is for publishing a national implementation plan for the rollout of Fracture Liaison Services; and what milestones have been set for achieving nationwide coverage by 2030.

Fracture Liaison Services are commissioned by integrated care boards, which are well-placed to make decisions according to local need.Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.Officials continue to work closely with NHS England to explore a range of options to provide better quality and access to these important preventative services.

How many Golden Hello scheme places were filled at the end of 2024-25; whether he has extended the recruitment period for dentists under that scheme; and when recruitment for dentists under that scheme will end.

Integrated care boards are continuing to recruit dentists through the Golden Hello scheme. The scheme offers a £20,000 recruitment incentive payment to dentists to work in those areas that need them most for three years. The recruitment of dentists in underserved areas remains a priority.Golden Hello data will be published this year and will consist of data showing the regional distribution of the original allocation of posts and the number of posts recruited to at both a national and regional level.

Pursuant to the Answer of 17 February 2025 to Question 29847 on Death Certificates, if he will publish the findings of his Department's monitoring of the impact of the death certification reforms on the time taken to register deaths.

We believe the answer of 17 February 2025 refers to the answer given to Question 29570. The Department’s monitoring of the impact of death certification reforms, including the time to register a death, includes consideration of:the annual report of the National Medical Examiner, which was published on 11 September 2025, and the next annual report is expected in early Summer 2026. The report published on 11 September 2025 is available at the following link: https://www.england.nhs.uk/long-read/national-medical-examiner-report-2024/;published data from the Office of National Statistics (ONS), including the Analysis of death registrations since death certification reform, published on 9 October 2025, and we expect the ONS to publish a further report later in 2026. This report is available at the following link: https://www.england.nhs.uk/long-read/national-medical-examiner-report-2024/; andfeedback from a wide range of partners including NHS England, the National Medical Examiner, the Welsh Government, the General Register Office, the funeral sector and faith groups, and the Royal College of Pathologists.

What steps her Department is taking to address the postcode lottery in NHS mental health support for bereaved parents following pregnancy or baby loss; and whether she will commit to issuing national standards for Integrated Care Boards to ensure all bereaved parents, including fathers and partners, can access specialist psychological support.

The Government recognises that the experience of losing a baby or pregnancy loss can be very difficult for parents and families.Maternal Mental Health Services are available in all integrated care board areas in England and provide care for women with moderate, severe, or complex mental health difficulties arising from baby loss.Additionally, all NHS England trusts have signed up to the National Bereavement Care Pathway, which acts as a set of standards and guidance aimed at ensuring all families, including fathers and partners, receive consistent, individualised, and sensitive care.Fathers and partners can receive evidence-based assessment and support through Specialist Perinatal Mental Health Services. Where partners may have a need for mental health support but is not a moderate or severe mental health condition, it is important they can be signposted to other forms of support through their general practice and NHS Talking Therapies.

What estimate his Department has made of the number of additional fully qualified full-time equivalent GPs required in England to restore the GP-to-patient ratio to 2015 levels.

The number of patients per full time equivalent (FTE) fully qualified general practitioner (GP) was 1,938 in September 2015 compared to 2,133 in January 2026, including GPs employed by primary care networks. To reach the same number of patients per fully qualified GP today, we would need an additional 3,012 FTE GPs. However, the GP workforce has changed significantly since 2015 with a wider range of professionals working in GPs. There’s currently an additional 38,265 FTE direct patient care staff working in primary care, including nurses, physiotherapists, and pharmacists.Thanks to actions taken by the Government, we currently have the highest number of fully qualified GPs since 2015, and steps are being taken to grow the GP workforce further. As part of the 2026/27 GP Contract, we are increasing the flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner. Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level GP reimbursement scheme which ring-fences and repurposes £292 million of funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions with existing GPs to improve access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment.

What assessment he has made of the potential implications for his policies of the pathways used by other Common Travel Area countries to enable qualified medical professionals from outside the EEA to practise medicine; and what steps he is taking to reduce barriers to registration for qualified international medical graduates.

No assessment has been made by the Department of the potential policy implications of the pathways used by other Common Travel Area countries to enable qualified medical professionals from outside the European Economic Area to practise medicine in the United Kingdom.The General Medical Council (GMC) is the independent regulator of medical practitioners, or doctors, in the UK. It is responsible for setting standards that must be met by both domestic and international applicants wishing to be added to their registers to ensure registrants are safe to practise.As the independent regulator, it is for the GMC to determine routes to registration and the qualifications that it will accept for registration.In 2023, the Department amended the GMC’s legislation to provide greater flexibility to streamline the process for registering overseas-qualified medical professionals. Following these changes, the GMC introduced new specialist registration routes, including the Recognised Specialist Qualification pathway, which was launched on 15 May 2024. This enables the GMC to formally recognise suitable specialist qualifications from overseas for the purposes of UK Specialist and General Practitioner registration.

What steps is his Department taking to help ensure that patients who cannot access digital services are still able to obtain timely updates on referrals and care pathways.

National Health Service organisations must ensure all patients have equitable access to care, and that decisions or policies do not unfairly disadvantage people or lead to an increase in inequalities. All NHS organisations are legally obliged to not discriminate against patients or staff.This means that although we promote digital first services to those who choose to use them, a non-digital solution should be available for patients who cannot or do not wish to engage digitally to ensure continued, equitable access to care.These non-digital routes must be available for all services provided by NHS organisations.NHS England’s guidance makes clear that services must continue to provide updates through non‑digital routes, including phone, letters, and face‑to‑face contact. The Accessible Information Standard also requires NHS bodies to give information in formats that meet individual needs. These arrangements ensure patients who cannot use digital tools still receive timely updates about their referrals and care.

What steps his Department is taking to improve the accessibility and clarity of NHS information for patients navigating care pathways across primary and secondary care.

A revised Accessible Information Standard (AIS) was published on 1 July 2025 and can be found at the following link: https://www.england.nhs.uk/accessible-information-standard/ The revised standard requires those staff in relevant communication and information roles to be adequately trained. The AIS conformance criteria, published in 2016 and updated in June 2025, set out how organisations should comply with the AIS. NHS England is working to support implementation of the AIS to ensure that staff and organisations in the National Health Service are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.

What steps her Department is taking to address regional disparities in NHS mental health support for bereaved parents following pregnancy or baby loss; and if she will issue national standards for Integrated Care Boards to ensure all bereaved parents, including fathers and partners, can access specialist psychological support.

The Government recognises that the experience of losing a baby or pregnancy loss can be very difficult for parents and families.Mental health services are available in all areas of England for women who experience mental health difficulties during, or due to, their pregnancy, labour, or birth, including Maternal Mental Health Services that specialise in supporting women who have experienced loss.Additionally, all NHS England trusts have signed up to the National Bereavement Care Pathway (NBCP), which acts as a set of standard and guidance aimed at ensuring all families, including fathers and partners, receive consistent, individualised, and sensitive care. NHS England is working closely with the baby loss charity Sands to agree what steps are necessary to support a faster and more consistent implementation so that all women and families, no matter where they are, receive the support they need at such a difficult time.

What assessment she has made of the adequacy of violence prevention measures in accident and emergency departments; and what steps she is taking to help improve the safety of NHS staff working in A&E settings.

Everyone working in the National Health Service has a fundamental right to be safe at work, including those working in accident and emergency settings providing rapid and critical care.Individual employers are responsible for the health and safety of their staff, and they put in place measures, including, security, training, and emotional support for staff affected by violence.In April 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced that the Social Partnership Forum’s recommendations on tackling and reducing violence, part of the 2023 Agenda for Change pay deal, had been accepted in full. This includes measures to improve data and reporting, strengthen risk assessment, and improve training and support for victims. This will be bolstered by the introduction of a new set of staff standards, as detailed in the 10-Year Health Plan.

What guidance her Department provides on the complaints and redress routes available to vulnerable patients who have concerns about the contractual terms of telecare services to which they are referred following hospital discharge.

By law, all health and social care services must have a procedure for dealing efficiently with complaints, and anyone who has seen or experienced poor-quality care has the right to complain to the organisation that provided or paid for the care.Telecare is not a mandatory service for local authorities, but many choose to provide a telecare service due to its benefits. Some local authorities will also fully or partially fund telecare for some individuals based on a financial assessment. Local authorities are responsible for the contractual terms of telecare services that they provide, therefore in the first instance an individual should consider making a complaint with the relevant local authority.If an individual is not satisfied with the way a local authority has dealt with their complaint, they may escalate it to the Local Government and Social Care Ombudsman who can investigate individual concerns. The Local Government and Social Care Ombudsman is the independent complaints lead for adult social care and investigates complaints from those receiving social care.

What steps his Department is taking to ensure that contracts drawn up by telecare services provided by local authority-connected bodies comply with consumer protection legislation, data protection legislation, and do not disadvantage vulnerable clients.

Telecare is not a mandatory service for local authorities, but many choose to provide a telecare service due to its benefits. Local authorities are responsible for the contractual terms of telecare services that they provide. All public authorities are required to comply with current procurement legislation when procuring goods and services. This includes legislation relating to Data Protection and Consumer rights.The Department is developing national telecare guidelines to give commissioners, providers, and users clarity about what good telecare looks like now and in the future. This will support local authorities to commission safe, reliable, and digitally compatible telecare services that safeguard vulnerable telecare users.

What estimate his Department has made of the number of complaints received by NHS Trusts relating to end of life care priorities in hospitals; and what assessment he has made of the adequacy of (a) compliance by hospitals with established end of life care priorities and (b) communication with family members and next of kin regarding end of life care decisions.

The Department does not hold central estimates of the number of complaints National Health Service trusts receive specifically relating to end‑of‑life care priorities in hospitals. Complaints are managed locally by NHS organisations in line with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, NHS Complaint Standards (2022), and Health and Care Act 2022, which set out the requirements for handling complaints in all NHS bodies. Anyone can raise concerns about NHS care, and trusts must investigate these in accordance with the regulations.NHS England sets out clear expectations for high‑quality end‑of‑life care through statutory guidance and service specifications for integrated care boards (ICBs) on commissioning palliative care and end‑of‑life care services. Compliance with established end‑of‑life care priorities is monitored through existing assurance mechanisms. The Care Quality Commission assesses whether trusts have effective systems in place to recognise deterioration, safeguard vulnerable adults, and provide safe, compassionate care at the end of life. NHS England also annually assesses ICBs on how well they discharge their statutory functions, including commissioning high‑quality palliative care and end‑of‑life care.We recognise that high-quality palliative care and end-of-life care should include the opportunity for individuals to discuss their wishes and preferences so that these can be taken fully into account in the provision of their future care, also known as advance care planning (ACP).NHS England has published Universal Principles for Advance Care Planning. These principles facilitate a consistent national approach to ACP in England. The principles focus on the importance of providing opportunities for a person and their family or carers to engage in meaningful discussions, led by the person concerned, which consider that person’s priorities and preferences, including place of care, when they are nearing the end of life.

What steps his Department is taking to ensure that clinicians in emergency and urgent care settings receive adequate training in the recognition and management of hamstring avulsion injuries.

Regulated healthcare professionals need to meet the standards of proficiency, conduct, and performance set by the relevant professional regulator, which are independent of the Government. It is the responsibility of individual employers to ensure their staff have appropriate access to ongoing training and professional development to provide safe and effective care.

If his Department will review information on the NHS website regarding hamstring injuries to ensure it adequately reflects the potential severity of hamstring avulsion injuries and the possible need for surgical intervention.

Decisions on the need for magnetic resonance imaging (MRI) scans in the case of hamstring avulsion injuries are clinically led. The Department has not made an assessment of the adequacy of the relevant guidance.The hamstring injury page on the NHS.UK website was recently reviewed against the latest clinical evidence and updated in July 2025. The current page does alert users to the potential for a hamstring injury to be severe and require surgery, and where and when to get medical help. NHS England routinely updates the NHS.UK website in line with clinical evidence to ensure individuals with a potential hamstring injury are provided with the latest clinical evidence.The Department is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including for MRI. NHS England is taking steps to support MRI services to remain resilient, effective, and able to meet growing demand. Over the past five years, significant capital investment has been deployed to strengthen service resilience, increase capacity, and improve patient access. This has included funding for new MRI assets, upgrading existing machines with MRI acceleration software, and supporting trusts in replacing failing or outdated systems.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26, some of which will deliver new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.

What plans his Department has to increase MRI scanning capacity in the NHS.

We are committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including investment in new magnetic resonance imaging (MRI) scanners. This will speed up waiting times for tests, a crucial part of reducing overall waiting times and returning to the referral to treatment 18-week standard.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26 to support delivery of the NHS performance standards. This funding will deliver new community diagnostic centres, including new MRI scanners, new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.Further details and allocations will be set out in due course.

What assessment his Department has made of the adequacy of guidance for NHS trusts on the urgent provision of MRI scans for patients with hamstring avulsion injuries.

Decisions on the need for magnetic resonance imaging (MRI) scans in the case of hamstring avulsion injuries are clinically led. The Department has not made an assessment of the adequacy of the relevant guidance.The hamstring injury page on the NHS.UK website was recently reviewed against the latest clinical evidence and updated in July 2025. The current page does alert users to the potential for a hamstring injury to be severe and require surgery, and where and when to get medical help. NHS England routinely updates the NHS.UK website in line with clinical evidence to ensure individuals with a potential hamstring injury are provided with the latest clinical evidence.The Department is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including for MRI. NHS England is taking steps to support MRI services to remain resilient, effective, and able to meet growing demand. Over the past five years, significant capital investment has been deployed to strengthen service resilience, increase capacity, and improve patient access. This has included funding for new MRI assets, upgrading existing machines with MRI acceleration software, and supporting trusts in replacing failing or outdated systems.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26, some of which will deliver new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.