Written questions by Evans.

Pursuant to the Answer of 19 March 2025 to Question 33086 on Health Services: Waiting Lists, what assessment he has made of the potential implications for his policies of the findings of the recent report by the Institute for Fiscal Studies entitled Can the government achieve its 18- week elective waiting time target, published on 20 March 2025.

Tackling waiting lists is a key part of our Health Mission and a top priority for the Government. The Elective Reform Plan, published in January 2025, sets out a whole system approach to hitting the 18-week referral to treatment target by March 2029, and will ensure patients get the treatment they need faster and improve their experience of care.The Department routinely reviews and considers reports on a variety of topics to inform policy development.Planning Guidance for 2025/26 sets out the expectation of progress towards the target this year with an increase to 65% of patients waiting no longer than 18 weeks nationally by March 2026, with every trust expected to deliver a minimum five percentage point improvement on current performance. We make no apologies for setting stretching ambitions for the National Health Service and have been clear on the productivity efforts and reforms that are required to get there. We are closely monitoring performance and will work to ensure that our oversight and delivery standards provide the right incentives to drive reform and maximise progress.The Government is already making good progress on waiting lists, with the delivery of an additional two million operations, scans, and appointments, as a First Step. Since July, the waiting list has fallen by over 190,000, and we have seen significant improvements in getting more people diagnosed and starting treatment faster. We are also introducing funding for general practitioners to incentivise the use of Advice and Guidance, which is an effective way of reducing unnecessary demand into hospitals. We have implemented several innovative strategies to boost NHS productivity and reduce long waiting times, including the Further Faster 20 initiative, in which expert clinicians and managers are deployed into NHS trusts in areas with the highest levels of economic inactivity to get patients treated faster.

Pursuant to the Answer of 13 March 2025 to Question 34655 on Department of Health and Social Care: Workplace Pensions, by what date all affected individuals will be contacted under the revised delivery plan for remedial service statements.

I refer the Hon. Member to the Written Ministerial Statement HCWS566 which I gave on 31 March 2025.

Pursuant to the Answer of 13 March 2025 to Question 34655 on Department of Health and Social Care: Workplace Pensions, by what date his Department plans to finalise production of the revised delivery plan for remedial service statements.

I refer the Hon. Member to the Written Ministerial Statement HCWS566 which I gave on 31 March 2025.

Pursuant to the Answer of 13 March 2025 to Question 34655 on Department of Health and Social Care: Workplace Pensions, by what date her Department plans to communicate the revised delivery plan for remedial service statements to affected individuals.

I refer the Hon. Member to the Written Ministerial Statement HCWS566 which I gave on 31 March 2025.

Whether staff seconded from NHS England to a transitional operations team in his Departent will focus solely on the transfer of responsibilities from NHS England to the Department for Health and Social Care; and what steps he is taking to ensure that the work ordinarily undertaken by the staff who have been seconded will be completed.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements of the team required to support the creation of a new centre for health and care. The transition team will work across NHS England and the Department, bringing together the expertise and experience of both organisations.As we work to return many of NHS England’s current functions to the Department, we will continue to evaluate impacts of all kinds and take precautions to avoid disruption, including when staff have been moved to work on the transition.

What the cost to the public purse is of staff being made redundant from NHS England.

As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will consider carefully how any information is published. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while we are scoping the programme.

If he will publish modelling outlining the estimated cost of staff being made redundant from NHS England.

As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will consider carefully how any information is published. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while we are scoping the programme.

What assessment he has made of the potential impact of the minimum tapered annual allowance on trends in the levels of extra work taken on by (a) GPs and (b) consultants.

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.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. There is no clear evidence from National Health Service payroll data that the annual allowance pension tax regime constrains the activity of the consultant workforce in aggregate. Given measurement difficulty, no assessment has been made on the impact of the annual allowance pension tax regime on general practice activity, or consultant activity at specialty level.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.

What assessment he has made of the potential impact of the annual allowance threshold on trends in the levels of extra work taken on by (a) GPs and (b) consultants.

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.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. There is no clear evidence from National Health Service payroll data that the annual allowance pension tax regime constrains the activity of the consultant workforce in aggregate. Given measurement difficulty, no assessment has been made on the impact of the annual allowance pension tax regime on general practice activity, or consultant activity at specialty level.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.

Pursuant to the Answers of 21 March 2025 to Question 38389 on NHS England and Question 38390 on NHS England: Redundancy Pay, what the short-term upfront costs of integrating NHS England and his Department will be.

As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will consider carefully how any information is published. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while we are scoping the programme.

What estimate he has made of the cost to the public purse of the abolition of NHS England.

We recognise that there may be some short-term upfront costs as we undertake the integration of NHS England and the Department, but these costs and more will be recouped in future years as a result of a smaller, leaner centre. By the end of the process, we estimate that these changes will save hundreds of millions of pounds a year, which will be reinvested in frontline services.

Pursuant to the Answers of 21 March 2025 to Question 38389 on NHS England and Question 38390 on NHS England: Redundancy Pay, if he will publish modelling outlining (a) how the short-term upfront costs will be recouped; and (b) in which financial year those costs will be recouped.

As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will consider carefully how any information is published. At this stage it is too early to say what the upfront costs of integration are, including any redundancy, while we are scoping the programme.

Whether he has plans to use external consultants to support the transfer of NHS England responsibilities to his Department.

Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements of the team required to support the creation of a new centre for health and care.

What steps he is taking to increase the (a) recruitment and (b) retention of speech and language therapists.

Decisions about recruitment are matters for individual National Health Service employers. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.NHS England is leading the National 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.

Pursuant to the Answer of 20 March 2025 to Question 33084 on Pharmacy: Finance, when he plans to publish the independent economic analysis of National Health Service pharmacy funding.

NHS England commissioned Frontier Economics to undertake an independent economic analysis of National Health Service pharmacy funding in 2024. This report was published on 28 March 2025. We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, and 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 Department considered the increases in National Insurance contributions and the National Living Wage when consulting on the funding arrangements for community pharmacy. We have now agreed with Community Pharmacy England to increase the community pharmacy contractual framework to £3.073 billion from April 2025. This deal represents the largest uplift in funding of any part of the NHS, at over 19% across 2024/25 and 2025/26. This shows a first step in delivering stability for the future, and a commitment to rebuilding the sector.

If he will make an estimate of the cost to community pharmacies of the proposed increase in the National Living Wage from April 2025.

NHS England commissioned Frontier Economics to undertake an independent economic analysis of National Health Service pharmacy funding in 2024. This report was published on 28 March 2025. We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, and 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 Department considered the increases in National Insurance contributions and the National Living Wage when consulting on the funding arrangements for community pharmacy. We have now agreed with Community Pharmacy England to increase the community pharmacy contractual framework to £3.073 billion from April 2025. This deal represents the largest uplift in funding of any part of the NHS, at over 19% across 2024/25 and 2025/26. This shows a first step in delivering stability for the future, and a commitment to rebuilding the sector.

What steps he is taking to support the retention of GPs.

We are investing an additional £889 million through the GP Contract to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.Under recently announced changes to the GP Contract in 2025/26, the Additional Roles Reimbursement Scheme (ARRS) will become more flexible to allow primary care networks (PCNs) to respond better to local workforce needs. The two ARRS pots will be combined to create a single pot for reimbursement of patient facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.In a drive to recruit GPs via the ARRS and to bring back the family doctor, the salary element of the maximum reimbursement amount that PCNs can claim for GPs will be increased from £73,113 in 2024/25, the bottom of the salaried GP pay range, to £82,418, an uplift of £9,305, representing the lower quartile of the salaried GP pay range, as some GPs will be entering their second year in the scheme. Proportionate employer on-costs will also be included within the overall maximum reimbursement amount which PCNs will be able to claim.Our commitment to growing the GP workforce includes addressing the reasons why doctors leave the profession, and encouraging them to return to practice. We know that high workloads can be a key driver for GPs reducing their contracted hours or leaving the profession altogether. That’s why we are tackling morale through drivers such as growing the workforce and reducing bureaucracy through our Red Tape Challenge, to improve job satisfaction and reduce the risk of burnout.

If she will make an estimate of the cost to community pharmacies of the proposed increase in employer National Insurance contributions from April 2025.

NHS England commissioned Frontier Economics to undertake an independent economic analysis of National Health Service pharmacy funding in 2024. This report was published on 28 March 2025. We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, and 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 Department considered the increases in National Insurance contributions and the National Living Wage when consulting on the funding arrangements for community pharmacy. We have now agreed with Community Pharmacy England to increase the community pharmacy contractual framework to £3.073 billion from April 2025. This deal represents the largest uplift in funding of any part of the NHS, at over 19% across 2024/25 and 2025/26. This shows a first step in delivering stability for the future, and a commitment to rebuilding the sector.

With reference to the Written Statement of 3 March 2025 on the Outcome of the 25-26 GP Contract consultation, HCWS486, which 32 targets will his Department remove from GPs.

For the 2025/26 GP Contract year, the 32 Quality and Outcomes Framework indicators that were income-protected for 2024/2025 have been permanently retired. The 32 permanently retired indicators are listed in Annex B at the following link:https://www.england.nhs.uk/long-read/changes-to-the-gp-contract-in-2025-26/

What steps he is taking to improve access to speech and language therapy.

We inherited a broken National Health Service with waiting times across all areas unacceptably high. In his investigation into the NHS in England, Lord Darzi highlighted the crisis in children’s community services with too many children waiting too long for services, including speech and language therapy, impacting their wellbeing, education and life chances. Lord Darzi also made clear we need to need to focus on community services. Too many adults are waiting too long to receive speech and language therapy, negatively impacting their communication or swallowing abilities. Through our 10-Year Health Plan, we will shift healthcare from hospitals to community. This shift to community services, like speech and language therapy, helps to prevent costly and intensive support later. Through the 10-Year Health Plan, we will revisit the Long Term Workforce Plan to ensure we have the right staff delivering the right services in the right place. We continue to improve access to speech and language therapy, including though the Early Language and Support for Every Child (ELSEC) programme, with the Department of Education and NHS England. The ELSEC programme provides training and support to education settings, to increase their ability to support speech, language, and communication development.