Written questions by Evans.

What steps he is taking to increase the number of NHS roles for newly-trained GPs.

The Government has invested £82 million in the Additional Roles Reimbursement Scheme (ARRS), which has enabled the recruitment of more than 1,900 recently qualified general practitioners (GPs) in England since October. This will increase the number of available appointments, secure the future supply of GPs, and alleviate the pressure on those currently working in the system.Under recently announced changes to the GP contract in 2025/26, the ARRS will become more flexible to allow primary care networks to respond better to local workforce needs. The two ARRS pots have been combined to create a single pot for the reimbursement of patient-facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs.On 27 February, the Government and the British Medical Association agreed to the changes to the GP contract to fix the ‘front door’ of the National Health Service and bring back the family doctor. We are investing an additional £889 million in GPs for 2025/26, bringing total spend on the GP contract to £13.2 billion. This is the largest uplift to GP funding since the beginning of the five-year framework, and means we are reversing recent trends by allocating a rising share of NHS resources to GPs.

What recent progress he has made on implementing fracture liaison services in all parts of the country 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.

What assessment he has made of the adequacy of the availability of Designated Prescribing Practitioners for all foundation pharmacists starting their training in 2025.

Every foundation trainee pharmacist that has graduated against the 2021 standards for the initial education and training of pharmacists will require a Designated Prescribing Practitioner (DPP), a healthcare professional with independent prescribing rights, for example, a doctor, pharmacist, or nurse, during their foundation training period to support the supervision and assessment of prescribing activities. Under the terms of the Foundation Trainee Pharmacists National Recruitment Scheme, training providers are required to ensure that the trainee will have access to a DPP. Providers are also required to submit details of the DPP to NHS England once the trainee pharmacist commences in post. Trainee pharmacists in England start their foundation training in the 2025/26 year in two windows: 14 July 2025 to 4 August 2025, summer; and 20 October 2025 to 10 November 2025, autumn. To support the development of DPP capacity, NHS England continues to engage with training providers and invest in training for independent prescribers. From September 2026, all newly qualified pharmacists will be independent prescribers on the day of their registration, which will expand future availability of healthcare professionals who are qualified to become a DPP.

Pursuant to the Answer of 25 June 2025 to Question 60209 on Carers, what the outcomes were of the cross-Government meeting.

Unpaid carers play a vital role and can access support from adult and children’s social care and the National Health Service, as well as through benefits, employers, schools, colleges, and universities. However, we know that too often systems are disjointed, difficult to navigate, and don’t appropriately identify and communicate with carers.The Government is determined to work together to provide carers of all ages with the recognition and support they deserve.Ministers from the Department of Health and Social Care, the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education have convened twice this year to discuss support for unpaid carers and consider opportunities to provide further recognition and support. These are early meetings of a group exploring further ways in which carers can be supported, and as such it does not have a statutory remit.

Pursuant to the Answer of 25 June 2025 to Question 60209 on Carers, whether the cross-Government meeting has a statutory remit.

Unpaid carers play a vital role and can access support from adult and children’s social care and the National Health Service, as well as through benefits, employers, schools, colleges, and universities. However, we know that too often systems are disjointed, difficult to navigate, and don’t appropriately identify and communicate with carers.The Government is determined to work together to provide carers of all ages with the recognition and support they deserve.Ministers from the Department of Health and Social Care, the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education have convened twice this year to discuss support for unpaid carers and consider opportunities to provide further recognition and support. These are early meetings of a group exploring further ways in which carers can be supported, and as such it does not have a statutory remit.

Pursuant to the Answer of 25 June 2025 to Question 60209 on Carers, on how many occasions there has been a cross-Government meeting since July 2024.

Unpaid carers play a vital role and can access support from adult and children’s social care and the National Health Service, as well as through benefits, employers, schools, colleges, and universities. However, we know that too often systems are disjointed, difficult to navigate, and don’t appropriately identify and communicate with carers.The Government is determined to work together to provide carers of all ages with the recognition and support they deserve.Ministers from the Department of Health and Social Care, the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education have convened twice this year to discuss support for unpaid carers and consider opportunities to provide further recognition and support. These are early meetings of a group exploring further ways in which carers can be supported, and as such it does not have a statutory remit.

Pursuant to the Answer of 25 June 2025 to Question 60209 on Carers, who attends the cross-Government meetings.

Unpaid carers play a vital role and can access support from adult and children’s social care and the National Health Service, as well as through benefits, employers, schools, colleges, and universities. However, we know that too often systems are disjointed, difficult to navigate, and don’t appropriately identify and communicate with carers.The Government is determined to work together to provide carers of all ages with the recognition and support they deserve.Ministers from the Department of Health and Social Care, the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education have convened twice this year to discuss support for unpaid carers and consider opportunities to provide further recognition and support. These are early meetings of a group exploring further ways in which carers can be supported, and as such it does not have a statutory remit.

With reference to p.98 of the document entitled Fit for the future: 10 Year Health Plan for England, published on 3 July 2025, if he will list the training requirements identified as (a) irritating staff and (b) adding unnecessary burdens staff's working days.

The 10-Year Health Plan set out an action to review the amount of statutory and mandatory training that healthcare professionals are required to undertake. This follows a large national engagement exercise with members of the public and health and care staff. As part of this engagement, members of staff shared their poor experiences of mandatory training, citing that the training can be, repetitive or irrelevant to their role and takes them away from treating patients.The exact amount of statutory and mandatory training completed varies, depending on which organisation they work for, their role or roles, and the frequency of their movement between organisations, for instance resident doctors rotating between organisations may have to repeat some of the training.On average, it is estimated that nationally defined statutory and mandatory training takes up to eight hours or one day per person per year, and locally mandated training will add to this. This considerable investment of time must be balanced against the fact that this training is both important, for instance safety training and emergency preparedness training, and often required by law.

Whether his Department has made an assessment of the potential impact of the delays in issuing (a) remedial pension savings statements and (b) remedial service statements on patient care.

The delays related to remediable service statements should have no direct impact on patient care. The members facing immediate financial consequences from their remedy benefit choice are retired members of the NHS Pension Scheme.We understand from regular conversations with staff representatives that the highest-earning NHS Pension Scheme members have expressed concerns about predicting the tax consequences of taking on overtime prior to receiving a remedial pension savings statement (RPSS). Whilst no assessment has been made of the potential impact of RPSS delays specifically on patient care, there is no clear evidence from National Health Service payroll data that the annual allowance pension tax regime, to which RPSS’ relate, constrains the activity of the consultant workforce in aggregate. A range of factors may influence personal decisions around intentions to take on extra work, making it difficult to measure the unique impact of tax measures or statement delays.From 6 April 2023, the standard annual allowance threshold increased from £40,000 to £60,000, giving individuals scope for greater tax-free pension growth. The tapered annual allowance further restricts the amount of tax-free pension saving available to the very wealthiest in society. The taper applies when taxable earnings reach £200,000.Where NHS Pension Scheme members do incur annual allowance pension tax charges, these do not have to be met in the current tax year. The NHS Pension Scheme offers a Scheme Pays facility through which individuals can ask the scheme to pay the tax on their behalf in exchange for a fair reduction in the generous pension benefits paid at retirement.The NHS Business Services Authority is continuing work to deliver outstanding statements as quickly as possible, and a process is in place for members to self-identify for a prioritised statement.

Pursuant to the Answer of 24 February 2025 to Question 28133 NHS Business Services Authority: Workplace Pensions, whether the Pensions regulator has required the NHS Business Services Authority to remedy the (a) errors and (b) delays in NHS pensions.

The NHS Business Services Authority (NHSBSA) is in regular contact with The Pensions Regulator to report on the delivery of the McCloud remedy. They are following all advice, guidance, and recommendations put forward by the regulator.The NHSBSA has taken all available steps to bring in external support to boost its statement production capacity. It has also recruited significant numbers of staff and is reprioritising existing staff to support the implementation of the McCloud remedy. The Pensions Regulator is aware of the proactive measures that the NHSBSA is taking to rectify any previous statements where necessary.

With reference to the 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what assessment he has made of the potential impact of reducing the share of expenditure on hospital care on his Department's goal for 92 percent of patients to be treated within 18 weeks by 2029.

The Elective Reform Plan (ERP) sets out the reform and productivity efforts needed to achieve the target that 92% of patients wait no longer than 18 weeks from referral to treatment by 2029. The ERP includes several efforts which will see care delivered differently. This includes addressing the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce elective and cancer waits. We will upgrade the NHS App, so patients can book and rearrange appointments, choose which hospital to be treated at, receive test results, and choose if they want to be seen in person or remotely.The 10-Year Health Plan set out how we will take that further. At present, roughly 80% of all elective care does not require admitted treatment but takes place in outpatient settings, mostly in hospitals. By 2035, two thirds of this care will take place digitally or in the community closer to home, with patients able to access the best of their local hospital in a much more responsive way, such as via a local neighbourhood health centre or at home via digital channels. This will deliver more timely, efficient, and flexible care, which is better for patients and will mean we reduce the numbers joining the waiting lists in the first place.

When he expects the outstanding (a) remedial pension savings statements and (b) remedial service statements to be delivered.

We have commissioned the independent Chair of the NHS Pension Scheme Pension Board to lead an urgent and targeted review of the NHS Business Service Authority’s (NHS BSA) revised plans for the delivery of the McCloud remedy for NHS Pension Scheme members. This will provide an additional level of scrutiny and assurance of the NHS BSA’s delivery plan for the remaining statements. A further Written Ministerial Statement will confirm the new timetable once the review has reported.

How many and what proportion of remedial pension savings statements (a) remain outstanding and (b) have been issued.

As of 22 July 2025, 108,742 remedial pension savings statements have been issued to NHS Pension Scheme members. 34,404 members either have a statement outstanding or require further calculations to determine whether a statement is needed.

Whether he has made an assessment of the adequacy of the recovery pathways for the care of patients who have had a sudden cardiac arrest not related to myocardial infarction.

A cardiac arrest is caused by a dangerous abnormal heart rhythm, which occurs when the heart isn’t working properly and causes the heart to stop beating. Each year approximately 30,000 people receive resuscitation for an out of hospital cardiac arrest in the United Kingdom.Only one in 10 people that have a cardiac arrest survive to go home from hospital. Fast and effective action will help save the lives of people suffering a cardiac arrest, as the chances of survival from a cardiac arrest that occurs out of hospital doubles if the person receives immediate resuscitation or a high energy shock to the heart, known as defibrillation.The National Health Service committed to improving community first response and building defibrillator networks to help save 4,000 lives by 2028. This is being supported by educating the general public, including young people of school age, about how to recognise and respond to an out-of-hospital cardiac arrest.NHS England is also working with partners such as the British Heart Foundation (BHF) to harness new technology and ensure the public and emergency services are able to rapidly locate this life saving equipment in an emergency.Patients who survive cardiac arrest and their families are supported through referral to local NHS services, and this will include rehabilitation such as cardiac and neurological rehabilitation and mental health services for psychological support.There are different pathways for cardiac arrest survivors, depending on the severity of the damage caused by the cardiac arrest. For people being discharged from secondary care and those with ischemic heart disease, myocardial infarction, cardiac rehabilitation services are available in every region.In December 2024, to support local systems to commission high quality cardiac rehabilitation, NHS England published Commissioning standards for cardiac rehabilitation, which is available at the following link:https://www.england.nhs.uk/long-read/commissioning-standards-for-cardiovascular-rehabilitation/These standards of care complement the British Association of Cardiovascular Prevention and Rehabilitation’s Standards and Core Components document, published in 2023, to support the delivery of high-quality care and adherence to evidenced-based practice. Further information on the British Association of Cardiovascular Prevention and Rehabilitation’s Standards and Core Components document is available at the following link:https://static1.squarespace.com/static/66cc563eecc7a22020c7da6c/t/66ffa8f20aef5d0b272c6b0e/1728030962905/BACPR+Standards+and+Core+Components+2023.pdfThe national audit for cardiac rehabilitation assesses practices against these standards of care and publishes the results annually, with the 2024 report available at the following link:https://www.cardiacrehabilitation.org.uk/site/docs/NCP_CR%20Certification_Report_2024_Final.pdfNHS England is committed to improving support for cardiac arrest survivor. NHS England has provided additional funding to all ICBs to increase the provision of cardiac rehabilitation across England, where clinically indicated patients can access cardiac rehabilitation following cardiac arrest.For patients with more complex needs it may be appropriate for them to be referred to Level 1 or 2 inpatient specialist services for short term post-acute rehabilitation, which may be followed by specialist rehabilitation in the community as appropriate.Patients and their families may also be signposted to appropriate charities such as the BHF’s Cardiac arrest webpage and the Sudden Cardiac Arrest UK’s website, with further information available on both, respectively, at the following two links:https://www.bhf.org.uk/informationsupport/conditions/cardiac-arresthttps://suddencardiacarrestuk.org/

With reference to the 10 Year Health Plan for England: fit for the future, published on 3 July 2025, what steps he plans to take to ensure that people who need one will be able to get a same-day GP appointment.

Through our 10-Year Health Plan, it will be easier and faster to see a general practitioner (GP). The 8:00am scramble will end, we will train more doctors, and we will guarantee digital consultations within 24 hours. We have delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of National Health Service resources In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of 1,900 individual GPs into primary care networks across England, which has expanded capacity, and will help to make same-day appointments more available to the patients that need them. The new £102 million Primary Care Utilisation and Modernisation Fund will create additional clinical space within over 1,000 practices across England, enabling more appointments and supporting same-day access.

What assessment he has made of the potential impact of the information sharing duties in the (a) Children’s Wellbeing and Schools Bill and (b) Crime and Policing Bill on GPs.

The Government is committed to improving information sharing across services to help safeguard and promote the welfare of children. The Department of Health and Social Care is working closely with the Department for Education and the Home Office on their respective information sharing proposals, which are included in Department for Education’s Children’s Wellbeing and Schools Bill and the Home Office’s Crime and Policing Bill. The information sharing proposals aim to establish a clear and consistent process to share information. To support the formulation and test the feasibility of these proposals, we have engaged with health stakeholders, including general practitioners, though a variety of forums. We will continue to engage with health stakeholders as we plan for the effective implementation of the use of the single unique identifier, the information sharing duty, and the child sexual abuse mandatory reporting duty. The Department for Education has published an impact assessment on the Children’s Wellbeing and Schools Bill, which is available at the following link: https://www.gov.uk/government/publications/childrens-wellbeing-and-schools-bill-impact-assessmentsThe Home Office and the Ministry of Justice have published an impact assessment on the Crime and Policing Bill, which is available at the following link:https://www.gov.uk/government/publications/crime-and-policing-bill-2025-impact-assessmentsWe will continue to support the departments leading on the respective bills to review and update these documents, once the bills have completed their passages through the House of Lords.

With reference to 10 Year Health Plan for England: fit for the future, published on 3 July 2025, if he will publish a list of regulatory bodies he plans to merge or abolish.

The 10 Year Health Plan refers to bodies that are being abolished or merged. None of these are regulatory bodies, such as the Care Quality Commission, instead they perform other functions.As part of the 10 Year Health Plan, we are cutting the number of organisations, bodies and entities overwhelming the National Health Service system and taking focus away from basics of patient care.The changes we are making will improve quality and safety by making it clear where responsibility and accountability sits at all levels of the system, and making it easier for staff, patients, and users to directly feed into the system to improve quality of care.However, the 10 Year Health Plan and the Dash Review detail several other organisations that are planned to be abolished or have their functions transferred. These organisations are mentioned in the relevant publications and there are no additional plans to publish a list. The organisations which are impacted are:- NHS England;- the Health Services Safety Investigations Body;- the National Guardian’s Office;- Healthwatch England;- local Healthwatch organisations; and- Commissioning Support Units.

With reference to 10 Year Health Plan for England: fit for the future, published 3 July 2025, how the planned multi-neighbourhood providers covering large geographical areas will improve local continuity of healthcare.

The 10 Year Health Plan sets out our vision for a Neighbourhood Health Service that moves care closer to home. The Neighbourhood Health Service will embody our new preventative principle that care should happen as locally as it can, digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and only in a hospital if necessary.We will bring together teams of professionals closer to people’s home, including nurses, doctors, social care workers, pharmacists, health visitors, and more, to work together to provide comprehensive care in the community and improve local continuity of healthcare. We expect neighbourhood teams and services to be designed in a way that meets the needs of local populations.Multi-neighbourhood providers will facilitate the development of neighbourhood teams, improving access for local populations and supporting the continuity of care for patients in a Neighbourhood Health Service. These providers will cover populations of approximately 250,000 people, to unlock the advantages and efficiencies possible from greater scale, working across all general practices and small neighbourhood providers in their footprint. The introduction of the Single Patient Record will support this way of working, giving neighbourhood clinicians secure access to a patient’s medical records to ensure seamless care across services.

What the underspend was in the additional roles reimbursement scheme in each year since it was launched.

The table attached provides a funding and spending summary for the Additional Roles Reimbursement Scheme, from 2019/20 to 2024/25.

Whether the underspend in the additional roles reimbursement scheme has been reallocated.

The table attached provides a funding and spending summary for the Additional Roles Reimbursement Scheme, from 2019/20 to 2024/25.