Written questions by Jarvis.

What steps he is taking to introduce early diagnosis services for osteoporosis.

On 6 January 2025, NHS England published the new Elective Reform Plan, which sets out a whole system approach to hitting the 18-week Referral-to-Treatment target by the end of this Parliament.Part of the plan sets out funding to boost bone density DEXA scanning capacity, to support improvements in early diagnosis and bone health for conditions such as osteoporosis. This will provide an estimated 29,000 extra scans per year.As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) Musculoskeletal (MSK) Community Delivery Programme. With a £3.5 million funding boost, GIRFT teams will deploy their proven Further Faster model to work with integrated care board leaders to further reduce MSK community waiting times, including for those with osteoporosis, and improve data, metrics, and referral pathways to wider support services.

Whether he has made an assessment of the (a) efficacy of and (b) adequacy of the provision of Clozapine.

Clozapine is licenced by the Medicines and Healthcare products Regulatory Agency (MHRA). Products are licenced by the MHRA where the benefit-risk assessment has been found to be positive in relation to quality, safety, and efficacy. Clozapine is marketed in different strengths and formulations, for the following indications.Firstly, Clozapine is indicated in treatment-resistant schizophrenic patients and in schizophrenia patients who have severe, untreatable neurological adverse reactions to other antipsychotic agents, including atypical antipsychotics. Treatment resistance is defined as a lack of satisfactory clinical improvement despite the use of adequate doses of at least two different antipsychotic agents, including an atypical antipsychotic agent, prescribed for an adequate duration. Secondly, Clozapine is indicated in psychotic disorders occurring during the course of Parkinson's disease, in cases where standard treatment has failed. Further information is available on the MHRA’s website, which is available at the following link:https://products.mhra.gov.uk/The Department is not aware of any supply issues regarding the provision of this medicine. Furthermore, decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers are accountable for their prescribing decisions.It is for the responsible clinician to work with their patient and decide on the best course of treatment, with the provision of the most clinically appropriate care for the patient always being the primary consideration. Prescribers must always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed and that they take account of appropriate national guidance on clinical effectiveness, as well as the local commissioning decisions of their respective integrated care boards (ICBs). The National Institute for Health and Care Excellence (NICE) has developed a Quality Standard on psychosis and schizophrenia in adults. NICE quality standards are concise sets of statements designed to drive quality improvements within a particular area of care and cover the NHS, public health, and social care. The Quality Standard recommends that adults with schizophrenia that have not responded adequately to treatment with at least two antipsychotic drugs are offered Clozapine, and provides quality measures to be used by service providers, commissioners, and healthcare professionals to assess the quality of care or service provision.

Whether he plans to extend access to Pancreatic Enzyme Replacement Therapy.

Clinicians are responsible for making prescribing decisions for their patients, taking into account best prescribing practice and the local commissioning decisions of their respective integrated care boards. They are also expected to take account of appropriate national guidance on clinical and cost effectiveness.Pancreatic Enzyme Replacement Therapy (PERT) is used by patients with conditions such as chronic pancreatitis, type 2 diabetes, and cystic fibrosis, in addition to being recommended by the National Institute for Health and Care Excellence (NICE) for people with both operable and inoperable pancreatic cancer. The NICE has acknowledged that this is a priority area for quality improvement, and has included PERT in its quality standard for pancreatic cancer.

What steps his Department is taking to increase the accessibility of Fracture Liaison Services for people with osteoporosis.

Fracture Liaison Services (FLS) are a globally recognised care model and can reduce the risk of refracture for people at risk of osteoporosis by up to 40%. We remain committed to rolling out FLS across every part of the country by 2030. That is what the Secretary of State promised before the election, and what he is delivering. In the meantime, we are investing in 14 high-tech DEXA scanners, which are expected to provide an extra 29,000 scans to ensure people with bone conditions get diagnosed earlier.

What the average wait time in Southampton General Hospital's Accident and Emergency Department was in (a) December 2024 and (b) January 2025.

The data is not available in the format requested. The latest provisional published data for the median average time spent at emergency departments at the University Hospital Southampton NHS Foundation Trust for November 2024 was 232 minutes. Information relating to December 2024 will be published on 13 February 2025, and information relating to January 2025 will be published on 13 March 2025.

What steps he is taking to improve (a) diagnosis and (b) treatment pathways for patients with (i) hypermobile Ehlers-Danlos Syndrome, (ii) Postural Orthostatic Tachycardia Syndrome and (iii) Mast Cell Activation Syndrome.

The Government is committed to improving the lives of those living with rare diseases, such as hypermobile Ehlers-Danlos syndrome (hEDS) and mast cell activation syndrome. The UK Rare Diseases Framework sets out four priorities, collaboratively developed with the rare disease community, which include helping patients get a final diagnosis faster and improving access to specialist care, treatments, and drugs. We remain committed to delivering under the framework and will publish an annual England action plan in 2025. With over 7,000 identified rare diseases, the framework and action plans focus on shared challenges across all rare diseases.NHS England has a website page on hEDS and this notes the passing of information on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS) to help scientists look for better ways to prevent and treat this condition. NHS England’s website page is available at the following link:https://www.nhs.uk/conditions/ehlers-danlos-syndromes/Be Part of Research is a tool that can support people living with rare diseases in engaging with research. Currently on Be Part of Research there is a study recruiting those with hEDS to take part in research to help advance the understanding of diagnostic imaging in this condition. Further information is available at the following link:https://bepartofresearch.nihr.ac.uk/trial-details/trial-detail?trialId=24730&location=&distance=To improve awareness of postural orthostatic tachycardia syndrome (PoTS) amongst healthcare professionals, and specifically general practitioners, the Royal College of General Practitioners provides training on PoTS as part of its syncope toolkit. Further information is available at the following link:https://elearning.rcgp.org.uk/course/view.php?id=500In addition, the NICE has produced a clinical knowledge summary on blackouts and syncope, last updated in November 2023, which outlines how clinicians should assess and diagnose PoTS. The NICE’s clinical knowledge summary is available at the following link:https://cks.nice.org.uk/topics/blackouts-syncope/diagnosis/assessment/

What assessment he has made of the adequacy of NHS funded IVF treatment in Eastleigh constituency.

Funding decisions for health services in England are made by the integrated care boards (ICBs) and are based on the clinical needs of their local population. ICBs are expected to commission fertility services in line with National Institute for Health and Care Excellence’s (NICE) guidelines. We are aware that compliance with these guidelines is variable.The NICE is currently reviewing the fertility guideline and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. We expect this review to be published later in 2025.The Department is working with NHS England to consider future policy options to support ICBs to provide more equitable in vitro fertilization (IVF) services. No assessment has been made of the of NHS-funded IVF treatment in the Eastleigh consistuency.