Written questions by Evans.

What steps his Department has taken to keep local authorities informed on the developing situation on the winding up of NRS Healthcare Limited.

The principal responsibility for ensuring the provision of disability aids and community equipment lies with local authorities (LAs), as does the responsibility to maintain continuity of care for those who are eligible.Nonetheless, the Department has played a significant role in supporting LAs and the National Health Service in the period leading up to and following the insolvency of NRS Healthcare (NRS).Working closely with NHS England and the Department-funded Partners in Care and Health programme, the Department ensured that information was shared across LAs and local NHS partners and enabled co-ordinated discussions with NRS and alternative providers to ensure the continuity of care and to minimise disruption as alternative arrangements were finalised.The Department also made funding available to enable the Official Receiver to continue trading NRS for a limited period, once it became insolvent, in order to enable LAs to arrange alternative provision, to minimise the potential impacts on vulnerable individuals.The Department continues to monitor the situation closely and will support LAs to learn lessons and consider the implications for future resilience in this market.

Pursuant to the Answer of 23 June 2025 to Question 55468 on Gender Dysphoria: Health Services, what his planned timetable is for ensuring the delivery of a gender clinic in each region by 2026.

NHS England has established NHS Children and Young People's Gender Services in the North-West, South-West, and London regions, in 2024. A fourth service is planned to open in the East England region in January 2026, following a process of mobilisation over 2025. Work remains ongoing to establish commissioned services that provide a pathway for children and young people with gender incongruence in the other regions by March 2027, on a phased basis.

If he will undertake a review of the (a) fitting, (b) quality and (c) patient feedback on (i) post-surgery bras and (ii) breast protheses received through the NHS.

Decisions about the funding and provision of health services, including post-surgery bras and breast protheses, are the responsibility of local integrated care boards.NHS England funded audits into primary and metastatic breast cancer to help identify and reduce inequalities and variations in care. Using routine data collected on patients diagnosed with breast cancer in a National Health Service setting, the audits bring together information to look at what is being done well, where it is being done well, and what needs to be done better. Findings were published in September 2025, and the NHS is acting on the findings.Patient experience and outcomes remain a key priority for the Department, and we will continue to look for opportunities to improve all aspects of cancer care. The National Cancer Plan, due to be published early in the new year, will have patients at its heart and will cover the entirety of the cancer pathway, including people living with and beyond cancer.

For what reason the threshold for Pharmacy First payments has increased since July 2024.

As part of delivering Pharmacy First, pharmacy contractors receive a monthly fixed payment if they deliver a minimum level of activity. This level increased at set intervals between February 2024 and March 2025, as agreed with Community Pharmacy England and announced ahead of the start of the service, and as set out in the Drug Tariff. This balanced giving time for the service to embed and for public awareness to grow with ensuring that the service offers value for money.There has been a steady increase in the delivery of the service. In 2024/25, the number of Pharmacy First consultations grew by an average of 5% per month.Service delivery has been carefully monitored. In July, we changed the activity requirement by introducing a lower fixed payment of £500 to support those pharmacies with lower potential for delivery. Pharmacies delivering between 20 to 29 consultations now receive the lower fixed payment. The monthly payment of £1,000 for contractors delivering at least 30 consultations was maintained.There are currently no plans to change the minimum activity requirement.

Whether he has made an assessment of the potential impact of raising the threshold for Pharmacy First payments on the (a) number of pharmacies claiming payment for Pharmacy First consultations and (b) the total number of pharmacy first consultations undertaken.

As part of delivering Pharmacy First, pharmacy contractors receive a monthly fixed payment if they deliver a minimum level of activity. This level increased at set intervals between February 2024 and March 2025, as agreed with Community Pharmacy England and announced ahead of the start of the service, and as set out in the Drug Tariff. This balanced giving time for the service to embed and for public awareness to grow with ensuring that the service offers value for money.There has been a steady increase in the delivery of the service. In 2024/25, the number of Pharmacy First consultations grew by an average of 5% per month.Service delivery has been carefully monitored. In July, we changed the activity requirement by introducing a lower fixed payment of £500 to support those pharmacies with lower potential for delivery. Pharmacies delivering between 20 to 29 consultations now receive the lower fixed payment. The monthly payment of £1,000 for contractors delivering at least 30 consultations was maintained.There are currently no plans to change the minimum activity requirement.

Whether his Department plans to change the Pharmacy First payment threshold.

As part of delivering Pharmacy First, pharmacy contractors receive a monthly fixed payment if they deliver a minimum level of activity. This level increased at set intervals between February 2024 and March 2025, as agreed with Community Pharmacy England and announced ahead of the start of the service, and as set out in the Drug Tariff. This balanced giving time for the service to embed and for public awareness to grow with ensuring that the service offers value for money.There has been a steady increase in the delivery of the service. In 2024/25, the number of Pharmacy First consultations grew by an average of 5% per month.Service delivery has been carefully monitored. In July, we changed the activity requirement by introducing a lower fixed payment of £500 to support those pharmacies with lower potential for delivery. Pharmacies delivering between 20 to 29 consultations now receive the lower fixed payment. The monthly payment of £1,000 for contractors delivering at least 30 consultations was maintained.There are currently no plans to change the minimum activity requirement.

How much of the funding allocated to the Pharmacy First scheme has not been claimed by pharmacies because they did not reach the threshold since July 2024; and whether this money been reallocated.

As part of delivering Pharmacy First, pharmacy contractors receive a monthly fixed payment if they deliver a minimum level of activity. This level increased at set intervals between February 2024 and March 2025, as agreed with Community Pharmacy England and announced ahead of the start of the service, and as set out in the Drug Tariff. This balanced giving time for the service to embed and for public awareness to grow with ensuring that the service offers value for money.There has been a steady increase in the delivery of the service. In 2024/25, the number of Pharmacy First consultations grew by an average of 5% per month.Service delivery has been carefully monitored. In July, we changed the activity requirement by introducing a lower fixed payment of £500 to support those pharmacies with lower potential for delivery. Pharmacies delivering between 20 to 29 consultations now receive the lower fixed payment. The monthly payment of £1,000 for contractors delivering at least 30 consultations was maintained.There are currently no plans to change the minimum activity requirement.

Whether he has had recent discussions with Community Pharmacy representatives on the (a) effectiveness of the medicines margin and clawback system and (b) potential impact of the medicines margin and clawback system on the long-term financial sustainability of community pharmacies.

In reaching a settlement for the 2025/26 Community Pharmacy Contractual Framework (CPCF), detailed discussions were had with Community Pharmacy England (CPE), the representative body of pharmacy contractors, which included the medicine margin arrangements and the long-term financial sustainability of community pharmacies.The CPCF settlement for 2025/26, which was agreed with CPE, increased the allowed medicine margin to £900 million and included writing off £193 million of historic over delivered medicine margin. It was also agreed that should there continue to be further over delivery of medicine margin, requiring downward adjustments to reimbursement, consideration will be given to further strategies to stabilise category M.No assessment has been made specifically on the effectiveness of the medicine margin and clawback system in accounting for local variation in prescribing habits. However, as part of the CPCF settlement for 2025/26, we committed to pursuing a number of reimbursement arrangement developments to support fairer access to medicine margin regardless of local prescribing habits.

What assessment he has made of the effectiveness of the medicines margin and clawback system in accounting for local variations in prescribing habits.

In reaching a settlement for the 2025/26 Community Pharmacy Contractual Framework (CPCF), detailed discussions were had with Community Pharmacy England (CPE), the representative body of pharmacy contractors, which included the medicine margin arrangements and the long-term financial sustainability of community pharmacies.The CPCF settlement for 2025/26, which was agreed with CPE, increased the allowed medicine margin to £900 million and included writing off £193 million of historic over delivered medicine margin. It was also agreed that should there continue to be further over delivery of medicine margin, requiring downward adjustments to reimbursement, consideration will be given to further strategies to stabilise category M.No assessment has been made specifically on the effectiveness of the medicine margin and clawback system in accounting for local variation in prescribing habits. However, as part of the CPCF settlement for 2025/26, we committed to pursuing a number of reimbursement arrangement developments to support fairer access to medicine margin regardless of local prescribing habits.

With reference to the report from Together for Short Lives entitled Overstretched and underfunded: The state of children’s hospice funding in 2025, if he will review the disparity in per person funding from integrated care boards for (a) children and (b) young people in hospice care.

We want a society where every child receives high-quality, compassionate care from diagnosis through to the end of life.Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations.The Together for Short Lives report, Overstretched and underfunded: The state of children’s hospice funding in 2025, highlights variation in the ‘per person’ funding of charitable children’s hospices but does not take into account funding spent via National Health Services, which also supports children with palliative care and end of life care needs. In England, while the majority of palliative care and end of life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including children’s hospices, also play in providing support to children, and their loved ones, at the end of life.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. We will confirm funding for 2026/27 in line with usual processes and timelines for Government finances.I have tasked officials to look at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

If he will adopt the recommendations of the report by Together for Short Lives entitled Overstretched and underfunded: The state of children’s hospice funding in 2025.

We want a society where every child receives high-quality, compassionate care from diagnosis through to the end of life.Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations.The Together for Short Lives report, Overstretched and underfunded: The state of children’s hospice funding in 2025, highlights variation in the ‘per person’ funding of charitable children’s hospices but does not take into account funding spent via National Health Services, which also supports children with palliative care and end of life care needs. In England, while the majority of palliative care and end of life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including children’s hospices, also play in providing support to children, and their loved ones, at the end of life.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. We will confirm funding for 2026/27 in line with usual processes and timelines for Government finances.I have tasked officials to look at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

Pursuant to the Answer of 14 July 2025 to Question 64429 on Hospices: Children, what his planned timetable is for confirming funding arrangements for children's hospices for 2026/27.

We want a society where every child receives high-quality, compassionate care from diagnosis through to the end of life.Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations.The Together for Short Lives report, Overstretched and underfunded: The state of children’s hospice funding in 2025, highlights variation in the ‘per person’ funding of charitable children’s hospices but does not take into account funding spent via National Health Services, which also supports children with palliative care and end of life care needs. In England, while the majority of palliative care and end of life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including children’s hospices, also play in providing support to children, and their loved ones, at the end of life.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. We will confirm funding for 2026/27 in line with usual processes and timelines for Government finances.I have tasked officials to look at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10 Year Health Plan.The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.

Whether he has had discussions with the National Institute for Health Research on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

Whether he has had discussions with the General Pharmaceutical Council on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

Whether he has had discussions with the Royal College of General Practice on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

Whether he has had discussions with Health Education England on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

Whether he has had discussions with the Association of the British Pharmaceutical Industry on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

Whether he has had discussions with NHS Digital on reducing overprescribing.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not had any discussions with these organisations related to reducing overprescribing.The National Health Service and partner organisations are responding to the challenge of overprescribing, as set out in the Government’s review of overprescribing, Good for you, good for us, good for everybody, in September 2021.Progress has been made to implement the recommendations of that review, for example:- implementing the National Medicines Optimisation Opportunities for integrated care boards;- addressing problematic polypharmacy, when there is potential harm associated with taking multiple medicines;- delivering Structured Medication Reviews; and- publication of a repeat prescribing toolkit and oversupply dashboard to support general practices to identify oversupply and improve repeat prescribing processes.Offering treatments that are not medicines is also key to addressing overprescribing. Many other initiatives delivered across the NHS contribute towards this. These include delivery of personalised care and shared decision-making, NHS Talking Therapies for anxiety and depression, and social prescribing.We are continuing to address issues with the prescribing of medicines in line with the NHS’ 2025/26 priorities and operational planning guidance.

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.