Written questions by Evans.

How many Remedial Service Statements remain outstanding for each of the last 12 months.

The NHS Business Services Authority confirmed that as of 30 October 2025, 415,307 Remedial Service statements are outstanding.

How many and what proportion of GPs qualifying in summer 2025 have secured employment in the UK.

Doctors complete general practice (GP) training on a rolling basis throughout the year. Over 1,600 doctors completed the GP Specialty Training programme between June and August 2025. As general practices are independent businesses, data on the proportion of these GPs who have secured employment in the National Health Service in England is not available.To improve understanding of movement of doctors from GP training to the substantive workforce over time, NHS England publishes quarterly analysis of the last time doctors in their final year of GP specialty training can be identified in a general practice placement and the first time they can be identified in a substantive role recorded by a practice or Primary Care Networks in the National Workforce Reporting Service. This information is available at the following link:https://digital.nhs.uk/supplementary-information/2025/gpwf_st3_tracking_202509

Whether he plans to implement the recommendations of the report by Care England entitled The Current State of Dementia Diagnosis & Care in England, published on 31 July 2025.

The report highlights systemic challenges in dementia care. Our health system has often struggled to support those with complex needs, including those with dementia. This is why, under the 10-Year Plan, those living with dementia will benefit from improved care planning and better services.We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in the quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.The report recommends that a national standardised diagnostic pathway must be established, as well as a nationally mandated standard of care across every stage of the dementia care pathway.The Modern Service Framework for Frailty and Dementia will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.In developing the Modern Service Framework for Frailty and Dementia, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with dementia. As part of this exercise, we are considering all options, including reviewing metrics and targets.

What estimate he has made of the number of General Practice partners operating in England.

This data is published monthly by NHS England. The publication is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/primary-care-network-workforce/30-september-2025

Whether he plans to reform the general practice funding model.

We recognise the importance of ensuring that the funding for core general practice (GP) services is distributed equitably between practices across the country. My Rt Hon. Friend, the Secretary of State for Health and Social Care, announced on 25 June that, through the 10-Year Health Plan, the Government will review the GP funding formula, the Carr-Hill formula, with the aim of ensuring that resources are targeted where they are most needed.In November, I wrote to MPs to inform them of the details of the review.The review is being conducted by the National Institute for Health and Care Research and the commencement of the review was announced on 9 October. Recommendations are expected in March 2026. The review will draw on a range of evidence and advice from experts, with a focus on how health need is reflected in funding. Ministers will then decide whether to proceed with the technical development and testing of a new formula, and any other changes motivated by the review.Implementation of any new funding approach will be subject to ministerial decision, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

Whether he has made an assessment of the potential impact of Pre-Visit Notifications on (a) vulnerable patients and (b) patients in care homes.

National Health Service funded domiciliary, or mobile, sight tests are available for patients eligible for free NHS sight tests and who are unable to leave home unaccompanied because of physical or mental illness or disability, and this includes individuals in residential care homes and nursing homes.Domiciliary eye care providers are required to give advanced notification to integrated care boards of their intention to provide an NHS domiciliary sight test to a patient. This is referred to as a pre-visit notification and includes the details of the contractor, where the visit will take place, and the names and dates of birth of the patients booked to have a sight test. Pre-visit notifications play an important role in safeguarding vulnerable groups.No discussions have taken place with the Welsh, Scottish, or Northern Irish administrations on removing the requirement for pre-visit notifications for domiciliary eye care services in England. NHS England and the Department are happy to engage with the primary eye care sector around the requirement for pre visit notifications to understand any concerns about pre-visit notifications.

Whether (a) he, (b) his Ministers and (c) official in his Department have held discussions with their counterparts in (i) Wales, (ii) Scotland and (iii) Northern Ireland on pre-visit notifications.

National Health Service funded domiciliary, or mobile, sight tests are available for patients eligible for free NHS sight tests and who are unable to leave home unaccompanied because of physical or mental illness or disability, and this includes individuals in residential care homes and nursing homes.Domiciliary eye care providers are required to give advanced notification to integrated care boards of their intention to provide an NHS domiciliary sight test to a patient. This is referred to as a pre-visit notification and includes the details of the contractor, where the visit will take place, and the names and dates of birth of the patients booked to have a sight test. Pre-visit notifications play an important role in safeguarding vulnerable groups.No discussions have taken place with the Welsh, Scottish, or Northern Irish administrations on removing the requirement for pre-visit notifications for domiciliary eye care services in England. NHS England and the Department are happy to engage with the primary eye care sector around the requirement for pre visit notifications to understand any concerns about pre-visit notifications.

What assessment his Department has made of the effectiveness of pre-visit notifications, in the context of mandatory electronic submissions of general opthalmic services claims.

Domiciliary eye care providers are required to give advance notification to integrated care boards (ICB) of their intention to provide a National Health Service domiciliary sight test to an eligible patient. This is referred to as a pre-visit notification (PVN) and includes the details of the contractor, where the visit will take place, and the names and dates of birth of the patients booked to have a sight test. Pre-visit notifications play an important role in safeguarding vulnerable groups.As part of the PVN process, contractors are required to seek a PVN number from their local ICB and to submit that information on the associated electronic claim form. Information about the number of PVNs submitted by optometrists is not held centrally but is held at an individual ICB level.

Whether his Department holds data on the number of pre-visit notifications completed by optometrists in the last 12 months.

Domiciliary eye care providers are required to give advance notification to integrated care boards (ICB) of their intention to provide a National Health Service domiciliary sight test to an eligible patient. This is referred to as a pre-visit notification (PVN) and includes the details of the contractor, where the visit will take place, and the names and dates of birth of the patients booked to have a sight test. Pre-visit notifications play an important role in safeguarding vulnerable groups.As part of the PVN process, contractors are required to seek a PVN number from their local ICB and to submit that information on the associated electronic claim form. Information about the number of PVNs submitted by optometrists is not held centrally but is held at an individual ICB level.

Whether he plans to remove the requirement for optometrists to complete Pre-Visit Notifications.

National Health Service funded domiciliary, or mobile, sight tests are available for patients eligible for free NHS sight tests and who are unable to leave home unaccompanied because of physical or mental illness or disability, and this includes individuals in residential care homes and nursing homes.Domiciliary eye care providers are required to give advanced notification to integrated care boards of their intention to provide an NHS domiciliary sight test to a patient. This is referred to as a pre-visit notification and includes the details of the contractor, where the visit will take place, and the names and dates of birth of the patients booked to have a sight test. Pre-visit notifications play an important role in safeguarding vulnerable groups.No discussions have taken place with the Welsh, Scottish, or Northern Irish administrations on removing the requirement for pre-visit notifications for domiciliary eye care services in England. NHS England and the Department are happy to engage with the primary eye care sector around the requirement for pre visit notifications to understand any concerns about pre-visit notifications.

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.

What assessment his Department has made of the potential impact of the insolvency of NRS Healthcare Limited on (a) patient care, (b) local authorities’ duty of care and (c) relevant contracted businesses.

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.

What steps he has taken to help mitigate the potential impacts of the insolvency of NRS Healthcare Limited on (a) the supply of medical equipment to patients, (b) local authorities and (c) relevant contracted businesses.

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.

What (a) due diligence and (b) risk management measures his Department undertook when it became aware of the likely 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.

What recent discussions she has had with (a) the police and (b) highways authorities about the (i) trends in the level of and (ii) reasons for equestrian related accidents and fatalities on roads.

Statistics on reported road collisions, including involving horses, are collated by the Department based on data supplied by police forces. While there is ongoing engagement with police and local authority data providers related to the data, no recent discussions have taken place specifically in relation to equestrian related incidents.

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.

Whether she has had recent discussions with (a) RMT and (b) Cross Country Trains to seek a resolution to avoid strike action and no service on the (i) Birmingham, (ii) Leicester, (iii) Cambridge and (iv) Stansted Airport line through Hinckley station on (A) Saturday 18 October and (B) Saturday 1 November 2025.

It is for CrossCountry, as the employer, to negotiate terms and conditions with their staff. Officials have been kept advised of the situation with the dispute. On Thursday 16th, sufficient progress had been made and RMT suspended strike action on Saturday 18th October, but unfortunately too late for many services to re-instated in a meaningful way. We understand CrossCountry talks continue with RMT on the remaining issues to resolve the dispute without further strikes.

What steps he is taking to improve probation services in the East Midlands.

We are committed to supporting probation staff and value their hard work, commitment and dedication. Following HM Inspectorate of Probation’s (HMIP) inspection of probation services in the East Midlands, their report identified areas of improvement, making 11 recommendations. 10 of these recommendations have been accepted in full, with the 11th being partially accepted. An action plan has been agreed with HMIP and delivery against that action plan is reviewed regularly by the Area Executive Director.To address workload pressures, we have implemented initiatives such as “Probation Reset” and “Impact” and launched the “Our Future Probation Service” programme, which aims to ensure that workloads for probation staff are sustainable by deploying new technologies, reforming processes and ensuring prioritisation of probation staff time. By the final year of the spending review period, there has been a commitment to increase funding by up to £700 million for the Probation Service. Recruitment remains a priority, with significant numbers of probation officer trainees onboarded in 2024/25 and a commitment to onboard a further 1,300 in 2025/26 nationally.These efforts are supported by a new wellbeing support model across HMPPS, including regional plans such as the Midlands wellbeing strategy, to ensure staff are supported in delivering their vital public safety responsibilities.

Food and Rural Affairs, what steps she is taking to determine the future of Animal Health and Welfare Pathway grants to support the transition to cage free systems for laying hens.

This Government was elected on a mandate to introduce the most ambitious plans to improve animal welfare in a generation. We remain firmly committed to maintaining and improving animal welfare and will continue to work closely with the farming sector to deliver high standards. The use of cages and other close confinement systems for farmed animals is an issue which we are considering very carefully. The Laying Hen Housing for Health and Welfare Grant, part of the broader Animal Health & Welfare Pathway, recently offered funding to commercial laying hen and pullet keepers in England to refurbish or replace housing, including for those transitioning from colony cages to high-welfare non-cage systems. The first stage of the application process closed in September 2024 with eligible applicants invited to submit a full application. Due to the extended timeframe of the grant, data regarding the assessment of potential impacts is not available.

What proportion of the £123 million allocated to the development of the Midlands Rail Hub has been assigned to design the East Chord of the Midlands Rail Hub.

In the 2025 Spending Review the Chancellor committed to progress the next stage of Midlands Rail Hub, which includes the East Chord, building on £123m previously released. Network Rail are procuring a contractor to design and build the scheme.