Written questions by Smart.

What assessment his Department has made of the potential merits of investing in mental health services to help tackle substance abuse.

The Government recognises the need for evidenced-based, high-quality drug and alcohol services, and will ensure that anyone with a substance use problem can access the help and support they need. To achieve this, we also recognise the vital need for high-quality integrated care for those with co-occurring mental health and substance use conditions.Local authorities are responsible for assessing the local need for alcohol and drug prevention and treatment in their area, and for commissioning services to meet these needs, whilst most mental health services in England are funded and commissioned by integrated care boards. There are currently no plans to change this arrangement, but we are working to promote more cohesive and joined up care between mental health and substance use services. In addition to the Public Health Grant, in 2025/26, the Department is providing a total of £310 million in additional targeted grants to improve drug and alcohol services and recovery support, which includes housing and employment. Alongside this, for 2025/26, mental health spending is forecast to amount to £15.6 billion. This represents a significant uplift in real terms spending on mental health compared to the previous financial year. Integrated care boards are forecast to meet the Mental Health Investment Standard over the 2025/26 financial year, meaning that local health services will invest a greater share of their budgets into frontline mental health services.In addition to continued investment, we intend to soon publish the Co-occurring Mental Health and Substance Use Action Plan, which has been co-produced between the Department and NHS England. The action plan provides national commitments and calls to the sector on how the health system can improve delivery of joined-up, person-centred care across drug and alcohol treatment and mental health services.Furthermore, the Office of Health Improvement and Disparities has published a Commissioning Quality Standard in 2022 which provides guidance for drug and alcohol treatment commissioners on improving services for people with co-occurring mental health and alcohol or drug conditions. This standard sets out that local services need to work together so that people can access the help they need for both their mental health and their alcohol or drug use.

What steps his Department is taking to improve access to NHS dental care for (a) pregnant women and (b) women in the postnatal period.

We are aware of the challenges faced in accessing a dentist and we want to make sure that everyone who needs a National Health Service dentist can get one, including pregnant women and new mothers. The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most.Pregnant women and women who have had a baby in the last 12 months are eligible for free NHS dental treatment. Further information is available at the following link:https://www.nhs.uk/nhs-services/dentists/get-help-with-dental-costs/The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Hazel Grove constituency, this is NHS Greater Manchester ICB.

Whether he plans to expand dental training programmes.

To reform the National Health Service and make it fit for the future, we have launched a 10-Year Health Plan as part of the Government’s five long-term missions.A central part of the 10-Year Health Plan 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.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade and treat patients on time again.We will ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need when they need it.

What recent assessment his Department has made of the potential impact of not including Stepping Hill Hospital in the New Hospital Programme on (a) patient and staff safety, (b) quality of care and (c) the condition and adequacy of the infrastructure at that hospital.

The Stockport Foundation NHS Trust submitted an expression of interest (EOI) to join the New Hospital Programme (NHP) in 2021, alongside other National Health Service trusts. The Department worked with NHS England on a joint prioritisation exercise assessing the EOIs in detail.All EOIs were scored against a series of indicators from four categories: deliverability; better and smarter use of NHS infrastructure; fairer allocation of investment and efficient use of public resources; and stronger and greener NHS buildings. This assessment was conducted in conjunction with an analysis of metrics covering estates, finance, and quality from existing national datasets. An assessment of these EOIs against regional strategic priorities was also conducted.In May 2023, the Government confirmed that five hospitals constructed primarily using reinforced autoclaved aerated concrete (RAAC) would be brought into the NHP, following a structural assessment by NHS England and the Department, which found that these hospitals would be unsafe to operate beyond 2030. Due to the size, complexity, and costs involved in rebuilding RAAC hospitals, it was not possible to invite other schemes to join.We are supporting the Stockport Foundation NHS Trust to improve the condition of the infrastructure at Stepping Hill Hospital, with up to £11.5 million from the critical infrastructure risk fund confirmed in 2024/25 to support the replacement of outpatient capacity and to deliver much needed improvements to patient and staff safety.

What steps his Department is taking to support to (a) local authorities and (b) Stockport Metropolitan Borough Council to identify new sites for the (i) expansion and (ii) development of existing hospital facilities.

The Government recognises that delivering high quality National Health Service healthcare requires the right infrastructure in the right places.Integrated care systems (ICSs) are responsible for strategic infrastructure planning as well as managing the operational capital for their respective local areas. This includes expanding and developing hospital facilities. The Department is supporting local NHS organisations to better manage their estates, and systems have developed infrastructure strategies which will inform their decision making and estate management.In this context, the Stockport Metropolitan Borough Council and other local authorities are encouraged to engage with their local integrated care board (ICB), the Greater Manchester ICB, to discuss opportunities for developing hospital infrastructure.

What recent assessment his Department has made of the potential impact of the maintenance and repairs backlog at Stepping Hill Hospital on the quality of patient care.

The Government recognises that delivering high-quality National Health Service healthcare requires safe and effective infrastructure.Integrated care systems (ICSs) are responsible for strategic infrastructure planning for their respective areas and were recently commissioned by NHS England to develop 10-year infrastructure strategies. As part of these strategies, systems assessed how the estate, digital, equipment, and workforce models contribute to the delivery of the overarching system strategy, related clinical pathways, and national priorities for delivering care. The strategies included consideration of the condition of the estate.In 2025/26, the Greater Manchester Integrated Care Board (ICB), responsible for Stepping Hill Hospital, has been provisionally allocated £187 million for operational capital, over £36 million for estates safety, and over £30 million to support constitutional standards recovery. The Stockport NHS Foundation Trust is encouraged to discuss options with the Greater Manchester ICB to allocate some of their operational capital and national programme allocations towards tackling the backlog of maintenance and ensuring that infrastructure supports quality care at Stepping Hill Hospital.We are pleased that despite challenging infrastructure, the Stockport NHS Foundation Trust has made progress towards reducing its waiting list. As of February 2025, there were 35,824 patient pathways waiting for a procedure. Of these, 54.3% of pathways were waiting within 18 weeks for a procedure. This compares to 50.3% of pathways waiting within 18 weeks for a procedure in February 2024.

Whether his Department has made an assessment of the potential merits of introducing incentive schemes to encourage NHS dentists to practice in areas that are experiencing a shortage of NHS dental professionals.

We are determined to rebuild National Health Service dentistry, but it will take time and there are no quick fixes. Strengthening the workforce is key to our ambitions.Integrated care boards have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.

What steps his Department is taking to improve access to cognitive behavioural therapy for people experiencing insomnia.

It is for local integrated care boards to decide whether cognitive behavioural therapy (CBT) should be offered to their populations as a treatment for insomnia.NHS Talking Therapies for anxiety and depression offers low-intensity therapy which may include interventions around sleep hygiene. Individuals who are experiencing symptoms of anxiety and/or depression can be referred by their general practitioner, or can self-refer, to NHS Talking Therapies. This is available via the following link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/Individuals can also access helpful resources on sleep problems on the Every Mind Matters website. This is available at the following link: https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/In addition, the National Institute for Health and Care Excellence’s Prioritisation Board has recently agreed to prioritise digital technologies that deliver CBT interventions for insomnia and insomnia symptoms as a topic for the development of HealthTech guidance.

What steps his Department is taking to improve access to cognitive behavioural therapy for autistic adults with (a) a gambling addiction and (b) other forms of addiction.

National Health Service treatment for those experiencing gambling-related harms is currently offered through 15 specialist clinics, representing every region of England. These clinics provide access to expert clinicians who are able to offer relevant psychological and psychiatric support, including cognitive behavioural therapy. The Department is also continuing to invest in local drug and alcohol treatment services.In addition, people, including autistic people, who are experiencing symptoms of anxiety and/or depression as a result of an addiction can be referred by their general practitioner, or can self-refer, to NHS Talking Therapies.Operational guidance for autism assessment services, published by NHS England in April 2023, sets out the expectation that primary and secondary mental health and psychological therapies services should make reasonable adjustments to routine care, so that it is more accessible for autistic people. Further information is available at the following link:https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/NHS England has also published guidance for NHS systems on how to improve the quality and accessibility of care and support for autistic adults to meet their mental health needs, which is available at the following link:https://www.england.nhs.uk/publication/meeting-the-needs-of-autistic-adults-in-mental-health-services/

What assessment his Department has made of the potential impact of differing pay and conditions between people employed by NHS Professionals Ltd and people directly employed by the NHS on (a) recruitment, (b) retention and (c) staff morale.

No such assessment has been made. National Health Service trusts will locally identify the mix of permanent and temporary staffing that fits their workforce requirements and delivers value for money. This can include the use of NHS professionals.The Government values the dedicated staff we have working in the NHS, and is committed to supporting them so that they can continue to thrive, and we can retain their valuable skills and experience within the NHS. NHS England is leading a national NHS retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

What the annual profits of NHS Professionals Ltd were in each of the last five years; and whether those profits were (a) reinvested into NHS service provision and (b) returned to his Department.

NHS Professionals Ltd (NHSP), a limited company wholly owned by the Department, is a supplier of clinical and non-clinical temporary workforce to client National Health Service trusts.The following table shows NHSP profit before tax and dividends paid to the Department over the last five years: Year Ended 31/3/24 £millionYear Ended 31/3/23 £millionYear Ended 31/3/22 £millionYear Ended 31/3/21 £millionYear Ended 31/3/20 £millionProfit before Tax3.78.516.818.911Dividends paidnil1018nil10Dividends received from NHSP are not ringfenced for specific purposes, but they are directly invested back into the wider healthcare economy by the Department. Where dividends are not taken, any profits generated are retained within the business and reinvested to support the delivery of its strategy.Full details of profits, dividend payments and declarations are shown in NHSP’s statutory accounts which are available at the following link:https://find-and-update.company-information.service.gov.uk/company/06704614

What information his Department holds on the number of contacts that UK NHS Ambulance Trusts have had with people who are (a) experiencing suicidal ideation and (b) committing suicide in each of the last five years.

This information is not held centrally. We know that suicide is complex and there are a range of factors outside of the mental health system that we will need to address if we are to achieve the Government’s aim.We will need to continue working across Government and with a wide range of organisations outside of Government to do this. That is why we have a dedicated cross-Government Suicide Prevention Strategy.We have commissioned research to explore why suicide rates amongst children and young people were increasing until recently. We expect the results to be published very shortly, and will use the findings to inform next steps.

How many hospital admissions were recorded for inflammatory bowel disease in the Hospital Episode Statistics dataset in (a) Hazel Grove constituency and (b) England in each of the last five years.

The following table shows the annual number of finished admission episodes with a primary diagnosis recorded for inflammatory bowel disease in England, in each of the last five years:YearFinished admission episodes2023/24358,0632022/23327,6932021/22308,5282020/21259,0582019/20282,335Source: Hospital Episode Statistics.Data on the number of admissions for the Hazel Grove constituency is not available.

Whether his Department plans to review Shared Care arrangements to ensure they are delivering effective outcomes for patients.

There are currently no plans to review shared care agreements.General practices (GPs) are independent contractors that provide National Health Services. Shared care agreements between a GP and a specialist are voluntary and are not part of the GP Contract. The General Medical Council is clear that a GP cannot be mandated to enter into a shared care agreement, and there is guidance in place to help GPs decide whether to accept shared care responsibilities.On initiating a treatment, the specialist clinician must follow General Medical Council guidance, that if continuation of the treatment is dependent on shared care, then an agreement with the GP must be in place before the treatment is started.

What steps his Department is taking to ensure that NHS documents are available in (a) large print, (b) braille and (c) other accessible formats for patients with visual impairments.

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 expected to meet the Accessible Information Standard (AIS), which details the approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss. This includes providing information in alternative formats such as large print and braille.NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force and therefore there should not be a gap in provision for people using services.

Whether his Department plans to raise the minimum reference range for vitamin B12 serum levels to 500 pmol/L.

The assessment and clinical management of vitamin B12 falls under the remit of the National Institute for Health and Care Excellence (NICE). In March 2024, the NICE published the guidance, Vitamin B12 deficiency in over 16s: diagnosis and management, which is available at the following link:https://www.nice.org.uk/guidance/ng239The guidance provides thresholds in table 1 to guide diagnosis. There are no plans to update this guidance at present.

What steps his Department is taking to improve the diagnosis of vitamin B12 deficiency and reduce the number of cases misdiagnosed as (a) dementia, (b) chronic fatigue syndrome and (c) psychiatric conditions.

The National Institute for Health and Care Excellence (NICE) published guidance in March 2024 on the diagnosis and management of vitamin B12 deficiency in over 16 year olds. The guidance is available at the following link:http://nice.org.uk/guidance/ng239It provides guidance to clinicians on recognising the symptoms of vitamin B12 deficiency, outlines the recommended diagnostic tests that should be carried out if vitamin B12 deficiency is suspected, and provides guidance on how to interpret the results from the diagnostic tests. Clinicians adhering to this guidance will help to minimise the number of B12 deficiency cases misdiagnosed as dementia, chronic fatigue syndrome, psychiatric conditions, or any other health condition.The NICE’s guidance is informed by clinical expertise, is evidence-based, and represents best practice. Healthcare professionals are expected to pay due regard to NICE guidance, although NICE guidelines are not mandatory and do not supersede the judgement and clinical discretion of clinicians in determining the most appropriate treatment for their patients.The NICE promotes its guidance via its website, newsletters, and other media. Healthcare professionals are responsible for ensuring that their own clinical knowledge remains up-to-date, and for identifying learning needs as part of their continuing professional development. This should include taking account of new research and developments in guidance, such as that produced by the NICE.

Whether his Department has made an assessment of the potential impact of changes in the level of staff overtime pay rates in emergency departments on (a) the quality of patient care and (b) the retention of senior clinical staff.

The Department has not made this specific assessment. Where national rates for overtime are applicable in England, these are set out in the national terms and conditions, and no recent changes have been made to these provisions, nor are there planned to be. Where pay for additional work is set at a local level or where local providers agree overtime rates that are different to those in the national terms and conditions, this would be considered a local matter.

Whether his Department has made an assessment of the potential merits of expanding standard NHS blood tests to routinely include (a) B12, (b) B6, (c) folate, (d) vitamin C and (e) vitamin D.

The Department has made no assessment of the potential merits of expanding standard National Health Service blood tests to routinely include B12, B6, folate, vitamin C, and vitamin D. The National Institute of Health and Care Excellence (NICE), which provides evidence-base guidance for the health and care system on best practice, makes recommendations on testing for vitamin deficiency based on symptoms and risk factors.NICE guidance makes recommendations on tests where the evidence supports their use in making a diagnosis, ruling out a condition, or for guiding treatment decisions. This is usually condition or symptom specific, and the NICE would not make recommendations on a ‘standard’ blood test or range of blood tests. NICE guidance is not mandatory, and therefore healthcare professionals should use their clinical judgement in deciding what blood tests should be carried out for individual patients, taking into account relevant national or local guidance, including NICE guidelines.

If he will take steps to help ensure that carers are (a) involved in patient care decisions and (b) given appropriate access to medical (i) records and (ii) updates during hospital stays in cases where patients have (A) cognitive and (B) neurological conditions.

The Health and Care Act 2022 introduced significant measures for people caring for their family and friends, as well as the people they are caring for. These include:provisions for integrated care boards to promote the involvement of patients and their carers and representatives, if any, in decisions relating to the prevention and diagnosis of illness, and the care and treatment of the person they care for; anda duty for National Health Service trusts and foundations to take any steps they consider necessary to involve patients and carers in discharge planning, where appropriate.Lord Darzi’s independent review of the NHS said that a fresh approach to supporting and involving unpaid carers is required to improve outcomes for carers, people needing care, and the NHS.We will carefully consider these findings as part of our 10-year plan for reforming and modernising the NHS and as we develop plans to reform adult social care, including through the National Care Service.