Written questions by Evans.

If he will meet (a) NHS England, (b) MHRA and (c) bodies supporting people affected by (i) Post-Finasteride Syndrome and (ii) Post-SSRI Sexual Dysfunction following the use of anti-depressant medication to discuss that issue.

Ministers meet regularly with external stakeholders on a variety of issues, including with organisations such as NHS England, the Medicines and Healthcare products Regulatory Agency (MHRA), and bodies representing patients affected by medicines and medical devices.The MHRA, as the regulator for medicines and medical devices, ensures that appropriate information is provided for each medicine on the United Kingdom’s market. The MHRA is currently reviewing the existing warnings in relation to sexual dysfunction which may continue after stopping anti-depressant medication, and recently completed an extensive safety review of finasteride and persistent sexual dysfunction, including after stopping treatment with finasteride.

If he will make an assessment of the potential merits of referring the NHS Business Services Authority to the Pensions Regulator, in the context of concerns with the annual allowance.

The NHS Business Services Authority has proactively informed the regulator of an error in the pension growth calculations which affects 2023/24 Pension Savings Statements.

Whether he has made an estimate of the potential (a) savings to the NHS, (b) impact on waiting times and (c) impact on the workload of GPs of proposals to pay GPs £20 per request for undertaking advice and guidance with hospital specialists.

Advice and Guidance services enhance two-way communication between clinicians in primary and secondary care, with a view to ensuring patients receive the right care, in the right clinical setting. The Elective Reform Plan has committed to ensuring general practitioners will receive £20 per Advice and Guidance request, to recognise the importance of the role that they play in the delivery of this important service.The Government has not made a standalone estimate of the potential savings to the National Health Service. This is not a new policy. Advice and Guidance has been shown to be successful in reducing demand on elective care by diverting potential referrals, where specialist advice determines that the most appropriate setting for care is in primary or community care. Approximately half of Advice and Guidance requests were diverted in 2023/24. Where advice from a specialist results in a patient being treated in a primary or community care setting instead of a referral to the waiting list, patients should be seen sooner, in a suitable setting closer to home, with the right course of action, benefiting from specialist input.

Whether his Department has made an assessment of the potential implications for his policies of comparative data for GPs undertaking advice and guidance with hospital specialists in different (a) geographical areas and (b) medical specialisms.

The Elective Reform plan commits to expanding the use of Advice and Guidance to ensure two-way communication between general practitioners (GPs) and hospital specialists, and ensure more patients are seen in the right clinical setting.Officials routinely review data on the variation in performance and delivery of interventions to reduce the waiting list. It is recognised that variation in the use of Advice and Guidance by specialty or within specialties, based on the local patient population, is to be expected. The Elective Reform Plan commits to actions to spread effective practices and address unwarranted variation, including in the uptake of Advice and Guidance, and will focus on the specialties where it demonstrates the most value to clinicians and to patients.In order to optimise the use of Advice and Guidance for both GPs and hospital specialists, the Elective Reform plan commits to providing access to new metrics and dashboards on the Model Health System, and to providing and regularly updating resources on referral optimisation, as well as the NHS England Getting It Right First Time team’s Advice and Guidance toolkits and templates.

What assessment he has made of the potential implications for his policies of the recent advice from the British Medical Association to stop engaging with advice and guidance pathways.

The Government is committed to delivering on its commitment in the recently published Elective Reform Plan to increase the use of Advice and Guidance by general practitioners (GPs), where appropriate, to support them to deliver high-quality patient care. The plan commits to paying GPs £20 per Advice and Guidance request in recognition of the fact that whilst it is a clinically helpful when used in the right circumstances, it can be time consuming.The consultation on the 2025/26 GP Contract has started with the General Practitioners Committee in England, of the British Medical Association, and a range of proposals will be considered, including Advice and Guidance arrangements. Ensuring Advice and Guidance arrangements are agreed as part of GP Contract negotiations is fundamental to ensuring that patients receive the right care, in the right clinical setting.

What discussions he has had with NHS England on which (a) straight-to-test pathways Community Diagnostic Centres and (b) hospital-based diagnostic services will be used to (i) develop and (ii) deliver its plan to reform elective care.

Currently, the waiting list stands at 7.48 million patient pathways, with over 6 million people waiting. As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from Referral to Treatment (RTT) by March 2029, a standard which has not been met consistently since September 2015.The Elective Reform Plan, published in January 2025, sets out an expectation that performance will increase from the current 58%, as of December 2024, to 65% by March 2026, with every trust expected to deliver a minimum 5% improvement by March 2026. The plan sets out the breadth of actions necessary to deliver on the RTT standard, including the efforts which will improve productivity, reform the system, and improve patient experience.The plan announced that the integrated care boards will make optimal use of the new diagnostic capacity by implementing the new standards for Community Diagnostic Centres (CDCs), in particular, increasing direct referrals and rolling out at least 10 straight-to-test pathways by March 2026.The Department has, and continues to hold, discussions with NHS England on the delivery of the plan, including ensuring that at least 10 straight-to-test pathways are fully developed and in place by March 2026, and will set out further detail at the earliest opportunity. Both CDC and hospital-based diagnostic services will be integral to the delivery of the Elective Reform Plan.

Whether his Department has made an assessment of the potential implications for his policies of alleged errors made by the NHS Business Service Authority on (a) doctors pensions saving statements and (b) the annual allowance.

The Department recognises that the service received by impacted individuals was not acceptable and will negatively impact their personal pension tax affairs. The Department became aware of a calculation error in 2023/24 Pension Savings Statements issued by the NHS Business Services Authority (NHSBSA) on 6 January 2025. NHSBSA is working with the Department and the British Medical Association to understand the impact on individuals, to rectify the issue and provide guidance and support with their next steps.

What recent discussions he has had with (a) NHS England and (b) social care providers on expanding opportunities for social prescribing.

The Department and NHS England work closely together to deliver the social prescribing work programme.I met with representatives of the National Academy for Social Prescribing (NASP) on 13 January, a key stakeholder in this field. At the meeting, I confirmed that the Department recognises the value of social prescribing for addressing the wider determinants of health. The NASP shared reports on the evidence for social prescribing and future opportunities for the development of work that they have identified.

Whether he has had recent discussions with the British Medical Association on proposals to pay GPs £20 per request for undertaking advice and guidance with hospital specialists.

In the Elective Reform Plan, the Government has proposed a £20 payment to general practitioners (GPs) per advice and guidance request. We expect this to increase the usage of advice and guidance, and help patients receive the care they need in primary and community settings, instead of being added to the elective waiting list. This funding will help deliver up to four million advice requests from GPs in 2025/26, up from 2.4 million in 2023/24, which we expect could increase diversions from elective care from 1.2 million in 2023/24 to two million in 2025/26. We are consulting with the General Practitioners Committee in England, of the British Medical Association, on the 2025/26 GP Contract, and will consider a range of proposed policy changes, including advice and guidance. These will be announced in the usual way following the close of the consultation in 2025.

Whether he has had recent discussions with (a) NHS England and (b) social care providers on increasing opportunities for social prescribing.

The Department and NHS England work closely together to deliver the social prescribing work programme.I met with representatives of the National Academy for Social Prescribing (NASP) on 13 January, a key stakeholder in this field. At the meeting, I confirmed that the Department recognises the value of social prescribing for addressing the wider determinants of health. The NASP shared reports on the evidence for social prescribing and future opportunities for the development of work that they have identified.

What estimate his Department has made of the size of the backlog of Remedial Pensions Savings Statements currently outstanding by the NHS Business Services Authority.

The Department understands that approximately 135,000 NHS Pension Scheme members may require a remedial pension savings statement as part of their remedy to the discrimination identified by the McCloud judgment. More than 70,000 statements have been issued to date, with approximately another 60,000 individuals still to be contacted. The Department understands the NHS Business Services Authority (NHSBSA) will issue the majority of these by the end of February 2025.The Department became aware of a calculation error in 2023/24 Pension Savings Statements issued by NHSBSA on 6 January 2025, and is working with the NHSBSA to ensure this is quickly rectified.

How many newly qualified GPs have been employed under the Additional Roles Reimbursement Scheme since August 2024.

Information on the number of recently qualified general practitioners (GPs) for which primary care networks are claiming reimbursement via the Additional Roles Reimbursement Scheme (ARRS) is currently being collated. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published.The Government has delivered an £82 million boost to the ARRS over 2024/25 to enable the recruitment of over 1,000 newly qualified GPs. My Rt Hon. Friend, the Secretary of State for Health and Social Care has confirmed that recently qualified GPs who are employed via the ARRS will continue to be supported through the scheme in 2025/26.

How many and what proportion of NHS staff have been vaccinated for flu (a) this year and (b) at this stage in the flu cycle in each of the last four years.

The UK Health Security Agency publishes monthly official statistics on flu vaccine coverage for frontline healthcare workers. The second monthly report of the 2024 to 2025 season was published on 19 December 2024, covering the period from 1 September to 30 November 2024, and is available at the following link:https://www.gov.uk/government/statistics/seasonal-influenza-and-covid-19-vaccine-uptake-in-frontline-healthcare-workers-monthly-data-2024-to-2025Data for the previous seasons is also available at the following link:https://www.gov.uk/government/collections/vaccine-uptake#seasonal-flu-vaccine-uptake:-figuresThe following table shows the percentage of seasonal flu vaccine uptake, the survey response rate, and the number of vaccinated people within those who answered the survey, rounded to the nearest hundred, from 2020/21 to 2024/25: 2024/252023/242022/232021/222020/21Percentage uptake32.2%38.5%41.8%52.5%70.6%Survey response rate79%79.8%90.4%82.3%96.1%Number of vaccinated survey responders333,100386,700461,000486,000750,800Notes:the data on the number of vaccinated survey responders is not extrapolated to represent a 100% response rate, as the number of vaccinated people is based on only those who have responded to the survey.the data for 2024/25 is not comparable to previous seasons due to this year’s programme starting four weeks later than previous seasons.the 2020/21 and 2021/22 seasons occurred during the COVID-19 pandemic.

If he will make an assessment of the adequacy of the level of uptake for the flu vaccine in each of the last four years for which data is available.

The Department works closely with the UK Health Security Agency and NHS England to encourage everyone who is eligible to get their flu vaccine. This is supported by a national Get Winter Strong marketing campaign to encourage uptake of the flu vaccine.For the autumn 2024 flu vaccination programme, NHS England has provided a range of resources and tools to support the vaccination offer to frontline health and social care workers. For example, National Health Service payslips were used to encourage eligible colleagues to get their vaccines, as were NHS social media channels, which included videos from spokespeople, including the Chief Nursing Officer for England, and resources and messages have been shared through established frontline health and care worker networks, including unions and representative bodies.There is also a comprehensive range of information leaflets, promotional materials, and other resources to inform members of the public and health care professionals. This includes leaflets translated into over 30 languages, and available in easy read and large print formats, braille, and British Sign Language. These are available at the following link: https://www.healthpublications.gov.uk/Home.htmlIn addition, improved reporting via NHS England’s Federated Data Platform is providing more detailed regional and integrated care board (ICB) level uptake intelligence than has been possible in previous campaigns. ICBs are being encouraged to work with the highest performing trusts in their region to share best practice and lessons learned, and to provide additional support for those providers where uptake is low. The UKHSA publishes weekly data on flu vaccine uptake in eligible groups, which is available at the following link:www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2024-to-2025-season The following table shows the latest data covering vaccination from 2021/22 up to 5 January 2025, as a percentage and broken down by patient group, and the comparative periods in previous years: Patient group2024/252023/242022/232021/2265-year-olds and over73.8%77.1%78.7%82.5%At risk38.6%40.4%46.7%53.0%Pregnant women33.8%31.0%33.6%39.8%Two-year-olds40.9%43.2%40.4%48.7%Three-year-olds42.5%43.5%42.9%50.7%The data for school aged children and health care worker vaccine uptake is published monthly, and is available, respectively, at the following two links: www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-children-of-school-age-monthly-data-2024-to-2025 www.gov.uk/government/statistics/seasonal-influenza-and-covid-19-vaccine-uptake-in-frontline-healthcare-workers-monthly-data-2024-to-2025The following table summarises the latest data on vaccination from 2021/22 up to 30 November 2024, for children in primary and secondary school and for health care workers:Cohort2024/252023/242022/232021/22Primary school49.1%48.1%48.0%39.5%Secondary school32.6%29.5%N/A26.2%Health care workers32.2%38.5%41.8%52.5% Adult social care setting vaccine uptake is published monthly, and is available at the following link:https://www.gov.uk/government/collections/monthly-statistics-for-adult-social-care-england#latest-reportThis year there was less time to complete vaccinations as the campaign for all adults, apart from pregnant women, started in early October 2024 rather than in September, as in previous years. This was based on the advice of the Joint Committee on Vaccination and Immunisation, that it is better to vaccinate closer to when flu circulates because of waning vaccine effectiveness.It should be noted that for most eligible groups, flu vaccination reached the highest levels of uptake ever achieved in the programme during the pandemic, but has dropped back since then in adults.

What steps his Department is taking to increase the level of flu vaccine uptake.

The Department works closely with the UK Health Security Agency and NHS England to encourage everyone who is eligible to get their flu vaccine. This is supported by a national Get Winter Strong marketing campaign to encourage uptake of the flu vaccine.For the autumn 2024 flu vaccination programme, NHS England has provided a range of resources and tools to support the vaccination offer to frontline health and social care workers. For example, National Health Service payslips were used to encourage eligible colleagues to get their vaccines, as were NHS social media channels, which included videos from spokespeople, including the Chief Nursing Officer for England, and resources and messages have been shared through established frontline health and care worker networks, including unions and representative bodies.There is also a comprehensive range of information leaflets, promotional materials, and other resources to inform members of the public and health care professionals. This includes leaflets translated into over 30 languages, and available in easy read and large print formats, braille, and British Sign Language. These are available at the following link: https://www.healthpublications.gov.uk/Home.htmlIn addition, improved reporting via NHS England’s Federated Data Platform is providing more detailed regional and integrated care board (ICB) level uptake intelligence than has been possible in previous campaigns. ICBs are being encouraged to work with the highest performing trusts in their region to share best practice and lessons learned, and to provide additional support for those providers where uptake is low. The UKHSA publishes weekly data on flu vaccine uptake in eligible groups, which is available at the following link:www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2024-to-2025-season The following table shows the latest data covering vaccination from 2021/22 up to 5 January 2025, as a percentage and broken down by patient group, and the comparative periods in previous years: Patient group2024/252023/242022/232021/2265-year-olds and over73.8%77.1%78.7%82.5%At risk38.6%40.4%46.7%53.0%Pregnant women33.8%31.0%33.6%39.8%Two-year-olds40.9%43.2%40.4%48.7%Three-year-olds42.5%43.5%42.9%50.7%The data for school aged children and health care worker vaccine uptake is published monthly, and is available, respectively, at the following two links: www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-children-of-school-age-monthly-data-2024-to-2025 www.gov.uk/government/statistics/seasonal-influenza-and-covid-19-vaccine-uptake-in-frontline-healthcare-workers-monthly-data-2024-to-2025The following table summarises the latest data on vaccination from 2021/22 up to 30 November 2024, for children in primary and secondary school and for health care workers:Cohort2024/252023/242022/232021/22Primary school49.1%48.1%48.0%39.5%Secondary school32.6%29.5%N/A26.2%Health care workers32.2%38.5%41.8%52.5% Adult social care setting vaccine uptake is published monthly, and is available at the following link:https://www.gov.uk/government/collections/monthly-statistics-for-adult-social-care-england#latest-reportThis year there was less time to complete vaccinations as the campaign for all adults, apart from pregnant women, started in early October 2024 rather than in September, as in previous years. This was based on the advice of the Joint Committee on Vaccination and Immunisation, that it is better to vaccinate closer to when flu circulates because of waning vaccine effectiveness.It should be noted that for most eligible groups, flu vaccination reached the highest levels of uptake ever achieved in the programme during the pandemic, but has dropped back since then in adults.

What assessment he has made of the adequacy of the levels of the uptake of the flu vaccine.

The Department works closely with the UK Health Security Agency and NHS England to encourage everyone who is eligible to get their flu vaccine. This is supported by a national Get Winter Strong marketing campaign to encourage uptake of the flu vaccine.For the autumn 2024 flu vaccination programme, NHS England has provided a range of resources and tools to support the vaccination offer to frontline health and social care workers. For example, National Health Service payslips were used to encourage eligible colleagues to get their vaccines, as were NHS social media channels, which included videos from spokespeople, including the Chief Nursing Officer for England, and resources and messages have been shared through established frontline health and care worker networks, including unions and representative bodies.There is also a comprehensive range of information leaflets, promotional materials, and other resources to inform members of the public and health care professionals. This includes leaflets translated into over 30 languages, and available in easy read and large print formats, braille, and British Sign Language. These are available at the following link: https://www.healthpublications.gov.uk/Home.htmlIn addition, improved reporting via NHS England’s Federated Data Platform is providing more detailed regional and integrated care board (ICB) level uptake intelligence than has been possible in previous campaigns. ICBs are being encouraged to work with the highest performing trusts in their region to share best practice and lessons learned, and to provide additional support for those providers where uptake is low. The UKHSA publishes weekly data on flu vaccine uptake in eligible groups, which is available at the following link:www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2024-to-2025-season The following table shows the latest data covering vaccination from 2021/22 up to 5 January 2025, as a percentage and broken down by patient group, and the comparative periods in previous years: Patient group2024/252023/242022/232021/2265-year-olds and over73.8%77.1%78.7%82.5%At risk38.6%40.4%46.7%53.0%Pregnant women33.8%31.0%33.6%39.8%Two-year-olds40.9%43.2%40.4%48.7%Three-year-olds42.5%43.5%42.9%50.7%The data for school aged children and health care worker vaccine uptake is published monthly, and is available, respectively, at the following two links: www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-children-of-school-age-monthly-data-2024-to-2025 www.gov.uk/government/statistics/seasonal-influenza-and-covid-19-vaccine-uptake-in-frontline-healthcare-workers-monthly-data-2024-to-2025The following table summarises the latest data on vaccination from 2021/22 up to 30 November 2024, for children in primary and secondary school and for health care workers:Cohort2024/252023/242022/232021/22Primary school49.1%48.1%48.0%39.5%Secondary school32.6%29.5%N/A26.2%Health care workers32.2%38.5%41.8%52.5% Adult social care setting vaccine uptake is published monthly, and is available at the following link:https://www.gov.uk/government/collections/monthly-statistics-for-adult-social-care-england#latest-reportThis year there was less time to complete vaccinations as the campaign for all adults, apart from pregnant women, started in early October 2024 rather than in September, as in previous years. This was based on the advice of the Joint Committee on Vaccination and Immunisation, that it is better to vaccinate closer to when flu circulates because of waning vaccine effectiveness.It should be noted that for most eligible groups, flu vaccination reached the highest levels of uptake ever achieved in the programme during the pandemic, but has dropped back since then in adults.

Whether he has had recent discussions with NHS England on flu vaccine uptake among staff working in (a) the NHS and (b) social care settings.

The Department works closely with the UK Health Security Agency and NHS England to encourage everyone who is eligible to get their flu vaccine. This is supported by a national Get Winter Strong marketing campaign to encourage uptake of the flu vaccine.For the autumn 2024 flu vaccination programme, NHS England has provided a range of resources and tools to support the vaccination offer to frontline health and social care workers. For example, National Health Service payslips were used to encourage eligible colleagues to get their vaccines, as were NHS social media channels, which included videos from spokespeople, including the Chief Nursing Officer for England, and resources and messages have been shared through established frontline health and care worker networks, including unions and representative bodies.There is also a comprehensive range of information leaflets, promotional materials, and other resources to inform members of the public and health care professionals. This includes leaflets translated into over 30 languages, and available in easy read and large print formats, braille, and British Sign Language. These are available at the following link: https://www.healthpublications.gov.uk/Home.htmlIn addition, improved reporting via NHS England’s Federated Data Platform is providing more detailed regional and integrated care board (ICB) level uptake intelligence than has been possible in previous campaigns. ICBs are being encouraged to work with the highest performing trusts in their region to share best practice and lessons learned, and to provide additional support for those providers where uptake is low. The UKHSA publishes weekly data on flu vaccine uptake in eligible groups, which is available at the following link:www.gov.uk/government/statistics/national-flu-and-covid-19-surveillance-reports-2024-to-2025-season The following table shows the latest data covering vaccination from 2021/22 up to 5 January 2025, as a percentage and broken down by patient group, and the comparative periods in previous years: Patient group2024/252023/242022/232021/2265-year-olds and over73.8%77.1%78.7%82.5%At risk38.6%40.4%46.7%53.0%Pregnant women33.8%31.0%33.6%39.8%Two-year-olds40.9%43.2%40.4%48.7%Three-year-olds42.5%43.5%42.9%50.7%The data for school aged children and health care worker vaccine uptake is published monthly, and is available, respectively, at the following two links: www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-children-of-school-age-monthly-data-2024-to-2025 www.gov.uk/government/statistics/seasonal-influenza-and-covid-19-vaccine-uptake-in-frontline-healthcare-workers-monthly-data-2024-to-2025The following table summarises the latest data on vaccination from 2021/22 up to 30 November 2024, for children in primary and secondary school and for health care workers:Cohort2024/252023/242022/232021/22Primary school49.1%48.1%48.0%39.5%Secondary school32.6%29.5%N/A26.2%Health care workers32.2%38.5%41.8%52.5% Adult social care setting vaccine uptake is published monthly, and is available at the following link:https://www.gov.uk/government/collections/monthly-statistics-for-adult-social-care-england#latest-reportThis year there was less time to complete vaccinations as the campaign for all adults, apart from pregnant women, started in early October 2024 rather than in September, as in previous years. This was based on the advice of the Joint Committee on Vaccination and Immunisation, that it is better to vaccinate closer to when flu circulates because of waning vaccine effectiveness.It should be noted that for most eligible groups, flu vaccination reached the highest levels of uptake ever achieved in the programme during the pandemic, but has dropped back since then in adults.

What estimate his Department has made of the percentage of funding announced in the Autumn Budget 2024 that will be allocated by NHS bodies to fund increases in National Insurance Contributions.

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 Budget announced the increase to the National Insurance contribution, but additional funding will be agreed with HM Treasury for 2025/26 separately, which is not included in the £22.6 billion increase.The Employer National Insurance rise will be implemented in April 2025, with the Department setting out further details on allocation of funding in due course, including through planning guidance.

Whether he plans to continue to support the TRANSFORM prostate cancer screening trial.

Research is crucial in tackling cancer, and the Government is strongly committed to supporting research into cancer. The Department spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer being the largest area of spend, at over £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group, reflecting its high priority.The TRANSFORM trial is an important example of prostate cancer research, as a £42 million screening trial which aims to find ways of detecting prostate cancer earlier. Prostate Cancer UK is leading the development of the trial, with the Government contributing £16 million through the NIHR. The TRANSFORM trial will also aim to address some of the inequalities that exist in prostate cancer diagnosis today, ensuring that at least 10% of the men who are invited to participate in the trial are black, to inform a targeted approach for earlier diagnosis.The NIHR welcomes funding applications for research into any aspect of human health, including prostate cancer. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.

What steps his Department plans to take to support (a) hospices, (b) GPs and (c) care homes, in the context of proposed changes to employer National Insurance contributions.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, which 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 employer National Insurance rise will be implemented April 2025, and the Department will set out further details on the allocation of funding for the next year in due course.