Written questions by Murphy.

What steps his Department is taking to ensure NHS Trusts comply with NICE CG143 and national sickle cell clinical standards in the management of acute sickle cell crises, particularly in relation to timely escalation of analgesia and adherence to individual care plans.

The NHS England Sickle Cell and Thalassaemia Improvement Programme aims to address health inequalities through targeted interventions. A key priority for the programme has been supporting National Health Service trusts in the management of acute sickle cell crises.The programme has rolled out seven sickle cell Emergency Department Bypass Accelerator Sites to provide rapid access to pain relief for uncomplicated vaso-occlusion crises. The sites across the country are mainly in areas with a high prevalence of sickle cell, with four based in London and three in the North of England. The accelerator sites operate a 24/7 service, providing patients with direct access to specialist sickle cell care, either through self-referral, ambulance pathways, or transfer between wards. An evaluation of the effectiveness of the units is being carried out by the National Institute for Health and Care Research with early indications suggesting significant improvements in time to analgesia as per the National Institute for Health and Care Excellence CG143 guideline. A full report is expected in Quarter four of 2026. In 2024, NHS England funded a programme of work to ensure that all patients with sickle cell in London and Greater Manchester have access to a personalised digital care plan, with an ambition to expand to other regions when the technology becomes available.

What steps are his Department taking to ensure NHS staff can recognise rheumatological symptoms and ensure urgent referral to rheumatology services.

The Royal College of General Practitioners has produced e-learning modules on a number of musculoskeletal (MSK) and rheumatic conditions, such as inflammatory arthritis, osteoarthritis, and axial spondyloarthritis, which are designed to help general practitioners and other primary care professionals recognise the symptoms of these conditions.Additionally, to support health and care professionals in the early diagnosis and management of different rheumatological conditions, the National Institute for Health and Care Excellence has published expert guidance on rheumatoid arthritis, osteoarthritis, and spondyloarthritis, with guidance for all three available, respectively, at the following three links:https://www.nice.org.uk/guidance/ng100https://www.nice.org.uk/guidance/ng226https://www.nice.org.uk/guidance/ng65The Getting It Right First Time (GIRFT) Programme for Rheumatology has made recommendations on the diagnosis and management of a range of rheumatic and MSK disorders and will support the National Health Service to deliver care more equitably across the country and closer to patients’ homes, and to improve services nationally. The GIRFT National Speciality Report included a number of recommendations designed to help support patients with non-inflammatory MSK conditions to be cared for in primary and community settings, freeing up capacity for those who need it to have urgent referrals to outpatient rheumatology services.

What steps are being taken to reduce access to treatment variations between ICBs for people with arthritis.

The Department is committed to improving timely diagnosis and management of arthritis and other musculoskeletal (MSK) conditions across England.The National Institute for Health and Care Excellence (NICE) has published guidance to support health and care professionals in the early diagnosis and management of rheumatoid arthritis and osteoarthritis. These guidelines help ensure that patients receive evidence-based care as early as possible.NHS England is working to improve early diagnosis rates through its Getting It Right First Time (GIRFT) rheumatology programme. This initiative focuses on reducing variation in care, improving referral pathways, and ensuring patients with suspected arthritis and other MSK conditions are assessed promptly by specialists.The Government has funded NHS England’s GIRFT programme to deploy its proven Further Faster model for MSK community services. The programme has been designed to reduce waiting times for community MSK appointments and to enhance access to quality treatment, working with integrated care board leaders to improve data and metrics and referral pathways to wider support services.We are working together to further develop the approach to better enable integrated care systems to commission the delivery of high quality MSK services in the community, which will benefit patients now and into the future.

What steps his Department is taking to ensure people are able to access a timely diagnosis for arthritis and musculoskeletal conditions.

The Department is committed to improving timely diagnosis and management of arthritis and other musculoskeletal (MSK) conditions across England.The National Institute for Health and Care Excellence (NICE) has published guidance to support health and care professionals in the early diagnosis and management of rheumatoid arthritis and osteoarthritis. These guidelines help ensure that patients receive evidence-based care as early as possible.NHS England is working to improve early diagnosis rates through its Getting It Right First Time (GIRFT) rheumatology programme. This initiative focuses on reducing variation in care, improving referral pathways, and ensuring patients with suspected arthritis and other MSK conditions are assessed promptly by specialists.The Government has funded NHS England’s GIRFT programme to deploy its proven Further Faster model for MSK community services. The programme has been designed to reduce waiting times for community MSK appointments and to enhance access to quality treatment, working with integrated care board leaders to improve data and metrics and referral pathways to wider support services.We are working together to further develop the approach to better enable integrated care systems to commission the delivery of high quality MSK services in the community, which will benefit patients now and into the future.

With reference to his Department's policy paper entitled Suicide prevention in England: 5-year cross-sector strategy, published on 11 September 2023, what steps his Department is taking to help provide postvention local support services.

We are committed to delivering the Suicide Prevention Strategy for England, which aims to reduce suicide rates and address the risk factors contributing to suicide, as well as improving support for those who have self-harmed or are bereaved by suicide.We are continuing to work towards the ambition and vision for improving bereavement support over the next five years, as set out in the strategy.NHS England commissioned the Support After Suicide Partnership to help local health systems to develop suicide bereavement and postvention support services, and which continues to offer support to local areas to embed suicide bereavement services in line with their core standards, which are available at the following link:https://hub.supportaftersuicide.org.uk/resource/summary-of-core-standards/A detailed description of the work involved can be found on their website, at the following link:https://hub.supportaftersuicide.org.uk/standards-intro/

What assessment his Department has made of the potential merits of providing funding to community-led suicide bereavement services.

We recognise the important role that community-led organisations can play in suicide prevention and suicide bereavement services. While there is no specific national funding allocated for suicide bereavement services, integrated care boards are responsible for commissioning health and care services to meet the needs of their local populations, which may include working with community-led organisations. As part of the 10-Year Health Plan, we are committed to working closely with voluntary, community, and social enterprise stakeholders as we begin this journey to transform mental health services, tackle the drivers of mental ill-health, and create the conditions to nurture good mental health and wellbeing for all.

What steps he is taking to ensure that families bereaved by suicide have access to local, specialist postvention support.

Commissioning responsibility for local suicide bereavement services, sits with integrated care boards (ICBs) and it is for them to commission appropriate services for their local population while considering their overall financial position. The NHS Long Term Plan committed that, from 2019/20, every area of the country would receive funding for suicide prevention and bereavement services by 2023/24. £57 million was allocated from the overall investment in mental health services in three annual waves via specific System Development Funding. Local systems had the flexibility to design bereavement services to best meet the needs of their local population, which could include peer support and specialist postvention services.From 2023/24, funding for local suicide bereavement services has been included within System Development Funding allocations for adult crisis services. ICBs are able to spend this wider allocation flexibly according to the needs of their local population and the amounts invested in local suicide prevention and bereavement services cannot be separately identified.

What steps he is taking to ensure adequate funding for grassroots organisations delivering peer support to people bereaved by suicide.

Commissioning responsibility for local suicide bereavement services, sits with integrated care boards (ICBs) and it is for them to commission appropriate services for their local population while considering their overall financial position. The NHS Long Term Plan committed that, from 2019/20, every area of the country would receive funding for suicide prevention and bereavement services by 2023/24. £57 million was allocated from the overall investment in mental health services in three annual waves via specific System Development Funding. Local systems had the flexibility to design bereavement services to best meet the needs of their local population, which could include peer support and specialist postvention services.From 2023/24, funding for local suicide bereavement services has been included within System Development Funding allocations for adult crisis services. ICBs are able to spend this wider allocation flexibly according to the needs of their local population and the amounts invested in local suicide prevention and bereavement services cannot be separately identified.

Whether he plans to review the adequacy of his Department’s oversight of NHS Property Services.

NHS Property Services is a company with all of the share capital owned by my Rt Hon. Friend, the Secretary of State for Health and Social Care. As a limited company regulated by the Companies Act, it is governed by a board consisting of a majority of non-executive directors, in line with best practise in corporate governance, and this includes a Shareholder Director appointed by my Rt Hon. Friend, the Secretary of State for Health and Social Care. Where the company needs to seek formal shareholder consent under the Articles of Association and its scheme of delegation, appropriate departmental approvals are sought. NHS Property Services publishes an annual statement of accounts, which sets out their performance against corporate key performance indicators agreed with the Department. The latest published set of accounts, setting out performance for the 2023/24 financial year, is available at the following link: https://www.property.nhs.uk/news-insights/news/annual-report-202324/ The 2024/25 accounts will be published in due course, which will confirm that the company has achieved 100% of its corporate key performance indicators for that year. In common with other wholly owned subsidiary companies and Arms Lenth Bodies, the Department holds quarterly accountability and performance reviews with the Chair and Chief Executive of NHS Property Services. As is required for all organisations that are arms-length from Government departments, regular periodic reviews are undertaken to ensure the form, function, and accountability arrangements remain appropriate.

What recent assessment he has made of the adequacy of the (a) performance and (b) level of accountability of NHS Property Services.

NHS Property Services is a company with all of the share capital owned by my Rt Hon. Friend, the Secretary of State for Health and Social Care. As a limited company regulated by the Companies Act, it is governed by a board consisting of a majority of non-executive directors, in line with best practise in corporate governance, and this includes a Shareholder Director appointed by my Rt Hon. Friend, the Secretary of State for Health and Social Care. Where the company needs to seek formal shareholder consent under the Articles of Association and its scheme of delegation, appropriate departmental approvals are sought. NHS Property Services publishes an annual statement of accounts, which sets out their performance against corporate key performance indicators agreed with the Department. The latest published set of accounts, setting out performance for the 2023/24 financial year, is available at the following link: https://www.property.nhs.uk/news-insights/news/annual-report-202324/ The 2024/25 accounts will be published in due course, which will confirm that the company has achieved 100% of its corporate key performance indicators for that year. In common with other wholly owned subsidiary companies and Arms Lenth Bodies, the Department holds quarterly accountability and performance reviews with the Chair and Chief Executive of NHS Property Services. As is required for all organisations that are arms-length from Government departments, regular periodic reviews are undertaken to ensure the form, function, and accountability arrangements remain appropriate.

Whether his Department has made an assessment of the potential merits of introducing enforceable limits on the number of children conceived from a single gamete donor.

The Human Fertilisation and Embryology Authority (HFEA), the United Kingdom’s fertility sector regulator, has advised that donor sperm, eggs, or embryos should not be used to create more than 10 families in the UK.The HFEA expects UK licensed clinics to ensure they do not breach the 10-family limit when using donors in treatment, as clearly specified in the HFEA Code of Practice. This limit only applies within the UK, so donors and recipients should be made aware that other countries might not have the same limits, or have no limits, on the number of children or families one donor can create.

Whether his Department plans to amend the Human Fertilisation and Embryology Act 1990 to reflect developments in reproductive technology.

The Human Fertilisation and Embryology Authority (HFEA) published Modernising Fertility Law in November 2023, which made a number of recommendations for legislative change, including around its regulatory powers. Ministers have met with the HFEA Chair and discussed the emerging regulatory challenges.The Government is considering the HFEA’s priorities for changing the law and will decide how to take this forward at the earliest opportunity.

What assessment his Department has made of the effectiveness of the Human Fertilisation and Embryology Authority in relation to the regulation of donor conception.

The Human Fertilisation and Embryology Authority (HFEA) is required by law to maintain records and make certain information available upon request to those affected by donor conception.The HFEA was subject to a Public Bodies Review in 2023, where all aspects of the HFEA’s activity and performance was considered. The report was published on 23 November 2023, and is available at the following link:https://www.gov.uk/government/publications/human-fertilisation-and-embryology-authority-hfea-review-report/independent-review-of-the-human-fertilisation-and-embryology-authority-hfea-final-report-and-recommendationsThe Department reviews performance through quarterly accountability meetings on a continuing basis, which takes account of the recommendations set out in the report.

What assessment his Department has made of the consistency of informed consent practices in donor conception.

The Human Fertilisation and Embryology Authority (HFEA) has advised that it sets out strict requirements in its Licence Conditions and Code of Practice in relation to obtaining informed consent from egg, sperm, and embryo donors and patients undergoing donor conception treatment.The HFEA Code of Practice requires licensed clinics to provide donors and patients with appropriate information and an offer of counselling prior to consent being given. At inspections, the clinic’s procedures for obtaining consent are reviewed to ensure that patients and donors have provided all relevant consents before undergoing any licensed activity. All inspection reports and decisions are published on the HFEA’s website.The Department reviews the HFEA’s performance through quarterly accountability meetings on a continuing basis.

What steps his Department is taking to ensure that (a) access to weigh in services with health visitors and (b) other postnatal support is provided (i) consistently and (ii) accessibly to new parents in (A) Basingstoke, (B) Hampshire and (C) England.

Local authorities have responsibility for commissioning public health services, including health visiting and services for all new parents. The Healthy Child Programme sets out the services and support families can expect and includes guidance on weighing, screening, immunisation, health improvement, wellbeing, and parenting, as well as five mandated health and development reviews.Department officials and NHS England have worked across the South East region to develop resources. This includes a Health Visiting Development Toolkit to help share best practice and ensure consistency.The Government is committed to raising the healthiest generation of children ever and strengthening the health visiting service. To achieve this, we must ensure that families have the support they need to give their babies and children the best start and the building blocks for a healthy life.

What assessment his Department has made of the potential merits of introducing a national system for tracking gamete and embryo donors.

The Human Fertilisation and Embryology Authority (HFEA), the United Kingdom’s fertility sector regulator, has advised that HFEA licensed clinics are required by law to provide treatment and outcome information on all gamete or embryo donations taking place at clinics. This information is published on the HFEA’s website. Clinics are required to monitor the usage of donor gametes and embryos in the UK, and to act in accordance with the guidance set out in the HFEA Code of Practice.The HFEA also runs the Opening The Register service, which enables people born through donor treatments in licenced clinics to trace their genetic origins.

What assessment his Department has made of the adequacy of training available to (a) Child and Adolescent Mental Health Services and (b) other healthcare staff on recognising and responding to anxiety-led behaviour in children.

It is the responsibility of each provider of mental health services to ensure that training meets the learning needs of their staff and that all staff adhere to and keep themselves appraised of National Institute for Health and Care Excellence guidance. Additionally, NHS England provides a number of further training programmes that are accessible to Child and Adolescent Mental Health Services and other healthcare staff. We will also publish a refreshed workforce plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.  We will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.

What steps his Department plans to take to use volunteers to help deliver NHS (a) resilience and (b) career pathways, in the context of the forthcoming 10 Year Plan.

The National Health Service has always benefited from the generous support of volunteers and voluntary sector organisations. Volunteers have, and will continue to have, an important and complementary role in the NHS and care system, supporting patients, families, and staff.A central part of the 10-Year Health Plan will be our workforce and those who support our workforce, so we can ensure that the NHS has the right people, in the right places, with the right skills to deliver the care patients need, when they need it.

What steps his Department is taking to increase (a) survival rates from out-of hospital cardiac arrests and (b) the availability of defibrillators in Basingstoke.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government has committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED Fund, launched in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.As part of the application process, the Department has selected Smarter Society as its independent partner to manage grant applications against requirements specified by the Department, to ensure that resources are allocated where there is the greatest need, for instance in remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest including sporting venues and venues with vulnerable people, and deprived areas.When an AED is installed, these defibrillators are required to be registered on The Circuit, the national defibrillator ambulance service database. Upon registration, contact details are provided for the nominated AED guardian/s who are local to the defibrillator’s location and conduct checks when required. Four AEDs have been distributed through the fund to the Basingstoke postcode area.

What steps his Department is taking to encourage community organisations in Basingstoke to register automated external defibrillators with the national defibrillator network.

To improve patients' survival rates following out-of-hospital cardiac arrests, the Government has committed to improving access to automated external defibrillators (AEDs) in public spaces and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED Fund, launched in September 2023, the Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.As part of the application process, the Department has selected Smarter Society as its independent partner to manage grant applications against requirements specified by the Department, to ensure that resources are allocated where there is the greatest need, for instance in remote communities with extended ambulance response times, places with high footfall and high population densities, hotspots for cardiac arrest including sporting venues and venues with vulnerable people, and deprived areas.When an AED is installed, these defibrillators are required to be registered on The Circuit, the national defibrillator ambulance service database. Upon registration, contact details are provided for the nominated AED guardian/s who are local to the defibrillator’s location and conduct checks when required. Four AEDs have been distributed through the fund to the Basingstoke postcode area.