Written questions by Taylor.

What steps the NHS is taking to provide better pain relief for people suffering from chronic urinary tract infections.

Treating clinicians use National Institute for Health and Care Excellence guidance, which helps practitioners and commissioners get the best care to patients, when assessing, signposting to, and prescribing pain relief medications. It is a prescriber’s duty when providing clinical care for conditions, such as urinary tract infections, to prescribe medicines, including pain relief, when they have adequate knowledge of the patient’s health and are satisfied that the medicine is clinically suitable for the patient.

What steps he is taking to improve access to mental health services for young people in London.

Too many young people are not receiving the mental health care they need, including in London and we know that waits for mental health services are too long. As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, we will recruit an additional 8,500 mental health workers across children and adult mental health services in England to reduce delays and provide faster treatment. We will also provide access to a specialist mental health professional in every school and roll out Young Futures Hubs in every community.There are currently approximately 65 locally-funded early support hubs in England offering early easy access mental health interventions to thousands of children and young people aged between 11 and 25 years old including those from low-income families.The Department is running an £8 million Shared Outcomes Fund project throughout 2024/25 to boost and evaluate the impact of 24 of these existing early support hubs, including two in London.

If he will take steps to increase diagnosis levels for genetic haemochromatosis.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service (GMS) and delivered by seven NHS Genomic Laboratory Hubs. Genomic testing for genetic haemochromatosis is available through the NHS GMS for all patients in England who show an unexplained iron overload, suggestive of hereditary haemochromatosis, to aid in the diagnosis of the disease. Any healthcare professional who suspects their patient may have haemochromatosis can refer their patient for testing via their local NHS Clinical Genomic Service. Individuals can discuss with their healthcare professional, for instance their general practitioner, whether genomic testing is appropriate for them.

What steps he is taking to help reduce the number of cases of late diagnoses of blood cancers in emergency NHS settings.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancer, as early and quickly as possible, and to treat it faster, to improve outcomes.The Department is committing to this by improving waiting times for cancer treatment, starting by delivering an extra 40,000 operations, scans, and appointments each week, to support faster diagnosis and access to treatment.In addition to improving cancer waiting time performance, the NHS has implemented non-specific symptom pathways for patients who present with vague and non-site-specific symptoms, which do not clearly align to a tumour type. This includes leukaemia, which the national evaluation found was one of the most common cancers diagnosed via these pathways.

Whether he has made an assessment of the effectiveness of non-specific symptom pathways in diagnosing blood cancers in each of the last three years.

We will get the National Health Service diagnosing cancer earlier and treating it faster, including blood cancer. This is supported by NHS England’s key ambition on cancer, to meet the Faster Diagnosis Standard, which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out.NHS England has implemented non symptom specific pathways for patients who present with non-specific symptoms, or combinations thereof, that can indicate several different cancers. This includes leukaemia, which can present non-specific symptoms, such as unexpected weight loss and night sweats. From our national evaluation, blood cancers are one of the most common cancer types diagnosed through these pathways.

What steps he is taking to ensure UK blood cancer patients can access effective new therapies that are available to patients overseas but have been subject to NICE terminated appraisals.

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE), following an evaluation of a treatment’s costs and benefits.The NICE process relies on the company to make an evidence submission. When the company does not make an evidence submission, the NICE is unable to develop recommendations, and the appraisal is terminated. NHS England’s default position is not to routinely commission a treatment where the company has not engaged in the NICE appraisal process. This is to avoid a potential pathway for circumventing the NICE process, that ensures value for the taxpayer.The Government encourages all companies to engage constructively in the NICE appraisal process. The NICE is able to recommend most medicines for use in the NHS where companies engage in the process, and has recommended 79% of cancer medicines that it has appraised. This includes many medicines for blood cancers, that are now available to NHS patients, including through the Cancer Drugs Fund, which makes promising new medicines available to patients while further evidence is collected to address uncertainties in clinical and cost-effectiveness.

Whether he plans to publish a 2024 progress report for the Family Hubs and Start for Life programme; and what steps he is taking to ensure that the programme continues to support (a) (i) perinatal and (ii) infant mental health and (b) parent-infant relationships.

Launched in August 2022, the three-year Family Hubs and Start for Life programme provides approximately £300 million to 75 local authorities in England with high levels of deprivation. The joint Department of Health and Social Care and Department for Education programme has created a network of Family Hubs with Start for Life services, which support the period from conception to the age of two years old, providing families with the support they need when they need it.While the Government does not have plans at this stage to publish a progress report on the Family Hubs and Start for Life programme, two national, independent evaluations are underway to understand implementation and impact.At the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer announced £69 million to continue delivery of a network of Family Hubs. The Department will confirm Start for Life funding for 2025/26 in due course, including support for perinatal mental health and parent-infant relationship services.

What information his Department holds on the average change in (a) stroke and (b) heart attack ambulance waiting times as a result of the London drop and go ambulance policy.

The Department does not hold the information requested. Category 2 ambulance calls are emergency responses, which can include serious time-sensitive incidents such as strokes and heart attacks. The following table shows the national and London Ambulance Service NHS Trust (LAS) Category 2 response times, displayed in minutes and seconds, for September 2024: Response timeLAS42:27England36:02Source: The data is published by NHS England, and is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

Whether he plans to review the National Institute for Health and Care Excellence's decision not to recommend Ruxolitinib for use within NHS England for the treatment of vitiligo.

The National Institute for Health and Care Excellence (NICE) is currently developing guidance for the National Health Service on whether ruxolitinib should be routinely funded by the NHS, based on an assessment of its costs and benefits.The NICE was unfortunately unable to recommend ruxolitinib as a clinically and cost-effective use of NHS resources in its final draft guidance published on 18 July. The NICE received four appeals against its draft recommendation which were heard by an independent panel on 11 October 2024. If any of the appeals are upheld, the NICE’s appraisal committee will reconsider its recommendations in light of the appeal panel’s decision.It is right that the NICE makes its decisions at arm’s length of the Government and in line with its carefully developed methods and processes. As such, it would not be appropriate for ministers to intervene in the NICE’s decision-making.

If he will make an assessment of the potential implications for his policies of the recommendations made in the UK Blood Cancer Action Plan, published by Blood Cancer UK on 4 September 2024.

I refer the Hon. Member to the answer I gave to the Hon. Member for Liverpool Walton to question 4539 on 19 September 2024.

If he will make palliative care training mandatory for health and social care workers.

The training of health care professionals is the responsibility of independent statutory health care regulatory bodies such as the General Medical Council (GMC), the Nursing and Midwifery Council, and the Health and Care Professions Council. The training curricula for postgraduate specialty training, including for palliative and end of life care, is set by the relevant royal college, and has to meet the standards set by the GMC.Additionally, to ensure the health and social care workforce is well equipped and supported in delivering personalised care to people at the end of life, Health Education England, now part of NHS England, hosts the End of Life Care for All e-learning training programme, which includes nine modules on improving care for people at the end of life.

What steps he is taking to increase access to medicines for patients receiving (a) palliative and (b) end of life care.

Local integrated care boards (ICBs) can commission out-of-hours dispensing locally if there is a need for patients to access medicines outside of the core pharmacy hours, including as part of any palliative and end of life arrangements that the ICB is required to make under statutory guidance.Adults in the last days of life who are likely to need symptom control should be prescribed anticipatory medicines with written instructions for how to use or administer treatment. The medicines are prescribed in advance so that they can be obtained during local pharmacy opening hours and kept safely at home, or at a care home, so that the person or their carer has access to them if they develop symptoms. The use of anticipatory prescribing is a quality standard in the National Institute for Health and Care Excellence’s guideline, Care of dying adults in the last days of life.

If he will publish independently-verified projections of future demand for the palliative and end of life care workforce at least every two years; and if he will take steps to ensure a properly resourced plan is in place for meeting this demand.

At this time, there are no plans to publish independently verified projections of future demand for the palliative and end of life care workforce. We will want to assure ourselves, and the National Health Service, that the current plan will deliver the reform needed. We will need to do this in light of the 10-Year Health Plan.