Written questions by Perteghella.

How many NHS GP practices in (a) England, (b) Coventry & Warwickshire, and (c) Stratford-on-Avon have declined to enter into shared care arrangements for ADHD medication prescribed by private providers in each integrated care board area in the most recent 12-month period for which data is available.

The data requested is not held centrally. The Coventry and Warwickshire Integrated Care Board has also confirmed that it does not hold the relevant data. The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has issued guidance on prescribing and managing medicines, which helps general practitioners (GPs) decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors such as whether the proposed activity is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes the GP being satisfied that any prescriptions or referrals for treatment are clinically appropriate.The GMC has made it clear that GPs cannot be compelled to enter into a shared care agreement. GPs may decline such requests on clinical or capacity grounds. If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician, which applies to both National Health Service and private medical care.

What discussions he has had with major retailers on improving access to affordable fresh food.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

How access to fresh food is being incorporated into the NHS Long Term Plan’s approach to tackling preventable diseases linked to diet.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What assessment his Department has made of the potential impact of limited access to affordable fresh food on health inequalities in rural areas.

The Government’s Eatwell Guide advises that people should eat plenty of fruit and vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and food and drink that is high in sugar, calories, saturated fat, and salt. This includes at least five portions of a variety of fruits and vegetables every day. Fresh, frozen, tinned, and dried fruit and vegetables all count. The Eatwell Guide indicates that many foods classified as ‘ultra processed’ such as crisps, biscuits, cakes, confectionery, and ice cream are not part of a healthy, balanced diet.The Department of Health and Social Care (DHSC) and the Department for Environment, Food and Rural Affairs (DEFRA), alongside other Government departments, are funding research on a number of food system trials through the SALIENT programme. The programme prioritises interventions and partners that have the largest reach and the greatest potential to narrow health inequalities, both geographic and socio-economic. These trials include research on food and vegetable pricing in supermarkets and evaluating the effect of food pantries on food insecurity. DEFRA’s 2024 report on food insecurity also considered inequalities in access to a healthy, sustainable diet.DHSC is working closely with DEFRA to develop their cross-Government Food Strategy, which aims to improve affordability and access to healthier food, to help both adults and children live longer, healthier lives. We are committed to making the healthier choice the easier choice.Earlier this year, the Government committed to reviewing the School Food Standards to reflect the most recent Government dietary recommendations. Free school meals will also be extended to all children from households in receipt of Universal Credit from September 2026, including in rural areas. Our free breakfast clubs started with 750 early adopter schools in April 2025, and we have just announced the next wave of 500 schools, with 40% of pupils on free school meals to benefit from the programme from April 2026. The aim of these programmes is to ensure children receive nutritious meals at school and to remove barriers to opportunity.Our Healthy Food Schemes, which comprises of Healthy Start, the School Fruit and Veg Scheme, and the Nursery Milk Scheme, provides support for those who need it the most to eat a healthy, balanced diet. Healthy Start provides funding to pregnant women, babies, and young children under four years old from very low-income households to support a healthier diet. In April 2026, the value of weekly payments will increase by 10%.DHSC is working at pace to develop proposals set out in our 10-Year Health Plan commitments, to introduce mandatory healthier sales reporting for large food businesses and then set new targets to increase the healthiness of sales.We will work closely with business to implement these commitments, and plan to conduct extensive engagement with industry and wider stakeholders throughout policy development. To assist us in the development of the mandatory reporting we will commence our formal engagement with businesses shortly. This will involve a series of workshops with a cross-sector industry working group.

What discussions he has had with NICE on (a) reviewing and (b) updating (i) clinical guidelines and (ii) guidance on diagnosing Type 1 Diabetes and Eating Disorders.

The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for determining whether its guidelines should be reviewed or updated in the light of new evidence. NICE takes a proactive approach to surveillance, monitoring for changes in the evidence base that may impact on its recommendations. Topics for new or updated guidance are considered through the NICE prioritisation process. Decisions as to whether NICE will create new, or update existing, guidance are overseen by a prioritisation board, chaired by NICE’s chief medical officer.NICE’s guidelines on the diagnosis and management of type 1 diabetes in adults, with the reference code NG17, diabetes, including both type 1 and type 2, in children and young people, with the reference code NG18, and the recognition and treatment of eating disorders, with the reference code NG69, will be reviewed if there is new evidence that is likely to change the recommendations. NICE currently has no plans to update NG17, NG18, or NG69.

If he will have discussions with his international counterparts on the potential merits of creating an international symposium of experts on Type 1 Diabetes and Eating Disorders to (a) share best practice and (b) agree consensus guidance on diagnosis and treatment.

There are regular opportunities for ministers to meet with their international colleagues on a range of health issues to discuss best practice and learning. For this reason, there are no current plans to arrange a specific symposium on diabetes.NHS England will continue its type 1 diabetes and disordered eating (T1DE) pilots, which have demonstrated that integrating diabetes and other health services, including mental health services, can significantly enhance the quality of life for people with T1DE and ultimately save lives.

If he will publish a national strategy for palliative and end of life care.

The Department and NHS England are currently looking 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.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 in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, from 2026/27 to 2028/29 inclusive, to be distributed again via integrated care boards. This amounts to approximately £80 million over the next three years.

What discussions he has had with NHS England on ensuring adequate numbers of NHS employees are available to administer Tofersen.

I have had no such discussions. The National Institute for Health and Care Excellence (NICE) has selected tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of National Health Service resources. If a positive recommendation is made, then NHS commissioners will be under a legal duty to fund the treatment for all eligible patients in England.

What steps his Department is taking to raise awareness of Type 1 Diabetes and Eating Disorders among healthcare professionals in diabetes and eating disorder services.

NHS England is currently funding five Type 1 Disordered Eating (T1DE) pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.Pilot sites are delivering a national high level service specification alongside testing local novel approaches to improving care including to awareness raising of the condition amongst both diabetes and eating disorder health care professionals. A national evaluation is currently underway to assess the impact of the five current pilot services. NHS England will review the evaluation findings to understand further opportunities to promote awareness of T1DE amongst healthcare professionals beyond the five pilot areas.NHS England works alongside its partners to support the delivery of key messages around diabetes education and awareness. This includes through a digital diabetes platform which is developing educational resources for T1DE.

Whether the NHS Workforce Plan will include measures to (a) recruit, (b) train, and (c) retain mental health professionals with specialism in Type 1 Diabetes and Eating Disorders (T1DE).

The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. To support this, the Department and NHS England will be engaging with key stakeholders to ensure that the needs of different patient groups and relevant health professionals are reflected in this work.

What steps his Department is taking to improve training for (a) GPs and (b) other healthcare practitioners to (i) recognise and (ii) manage Type 1 Diabetes and Eating Disorders (T1DE).

The standard of training for healthcare professionals is the responsibility of the independent professional regulators, who set the outcome standards expected at undergraduate level and approve courses and universities to write and teach the curricula content that enables their students to meet the outcome standards. Post-graduate training curricula is set by the relevant Royal College. Whilst not all curricula may necessarily highlight a specific condition, they all emphasise the skills and approaches a healthcare practitioner must develop to ensure accurate and timely diagnoses and treatment plans for their patients, including for type 1 diabetes with disordered eating.Employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver appropriate treatment for patients.

If his Department will take steps with (a) diabetes and (b) eating disorder charities to support national campaigns tackling (i) stigma and (ii) media representation of Type 1 Diabetes and Eating Disorders.

The national diabetes programme works closely with charity partners including Diabetes UK who take a multi-pronged approach to reducing stigma experienced by those with all types of diabetes. This includes raising awareness of the complex and serious nature of type 1 diabetes, including type 1 disordered eating (T1DE), providing support to those that experience stigma, and supporting research into stigma and how it can be reduced or prevented. NHS England is partnering with the National Institute for Health and Care Research to deliver a qualitative evaluation of the five current T1DE pilot sites. A core element of this approach has been engagement with service users to understand their experiences of having the condition, both before and during their involvement with the T1DE service. The National Diabetes Experience Survey led by NHS England is a further mechanism for understanding the experiences of those living with type 1 diabetes, including T1DE, to inform national and local approaches to improvement. In response to feedback on the experiences of people of all ages who live with diabetes, NHS England published the guide, Language Matters: language and diabetes, for health care professionals which sets out the good practice principles for interactions with people living with diabetes including around reducing stigma. The guide is available at the following link: https://www.england.nhs.uk/long-read/language-matters-language-and-diabetes/

What steps his Department is taking to (a) scope and (b) support the development of (i) moderated online, (ii) in-person and (iii) other models of peer support networks for people with Type 1 Diabetes and Eating Disorders (T1DE).

NHS England works in close partnership with national charities and organisations that support people living with type 1 diabetes, including by facilitating and supporting peer support opportunities.For example, NHS England has collaborated with Diabetes UK, Breakthrough Type 1 Diabetes and people with lived experience, to produce The Six Principles of Good Peer Support for People Living with Type 1 Diabetes statement which aims to promote the standards required for peer support to both clinicians and those who are looking to access peer support opportunities. These are available at the following link:https://www.england.nhs.uk/long-read/the-six-principles-of-good-peer-support-for-people-living-with-type-1-diabetes/Diabetes UK also runs the Together Type 1 Programme which aims to create a supportive environment where young people can connect with others who understand the challenges of living with type 1 diabetes. Diabetes UK also has a network of regional teams that facilitate local peer support groups and activities. More information on the programme is available at the following link:https://www.diabetes.org.uk/support-for-you/community-support-and-forums/type-1-youth-programme

What plans NHS England has to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes.NHS England is currently funding five Type 1 Disordered Eating (T1DE) pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.The National Institute for Health and Care Excellence (NICE) is responsible for producing clinical guidelines and quality standards for diabetes care.The current NICE guideline for type 1 diabetes diagnosis and management states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng17/resources/type-1-diabetes-in-adults-diagnosis-and-management-pdf-1837276469701

Whether NHS England plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes.

The National Health Service does not currently have any plans to introduce a mental health assessment to the annual care check for people with type 1 diabetes or to embed mental health support into all diabetes clinics to provide emotional wellbeing for people with type 1 diabetes.NHS England is currently funding five Type 1 Disordered Eating (T1DE) pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.The National Institute for Health and Care Excellence (NICE) is responsible for producing clinical guidelines and quality standards for diabetes care.The current NICE guideline for type 1 diabetes diagnosis and management states that members of diabetes professional teams should be alert to the symptoms of depression and anxiety, have the appropriate skills to provide basic management and arrange prompt referral to specialists where an individual’s mental health interferes significantly with their wellbeing or self-management. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng17/resources/type-1-diabetes-in-adults-diagnosis-and-management-pdf-1837276469701

Whether Integrated Care Boards will be required to provide sustainable funding for successful pilot projects on Type 1 Diabetes and Eating Disorders so that they can become regional centres of excellence.

NHS England has provided up to £1.5 million a year for the five current Type 1 Disordered Eating pilots for three years. This funding is transferred to integrated care boards on an annual basis and in 2025/26 has been ringfenced.Decisions on funding for future years have yet to be taken.

If he will make it his policy for NHS England to create a dedicated registry for people with (a) type 1 diabetes and (b) Type 1 Diabetes and Eating Disorders (T1DE) to improve (i) prevalence data and (ii) patient support.

The National Diabetes Audit is the primary mechanism for collecting data in England on the care and outcomes of people living with diabetes, helping to inform healthcare practice and policy. The National Diabetes Audit could serve as a registry for type 1 disordered eating (T1DE) in the future. An agreed definition of T1DE supported by the National Institute for Health and Care Excellence (NICE) will be important to enable diagnosis, data recording and establishing data collection processes. NHS England works closely with NICE to understand emerging areas for consideration in national guidance and has committed to share the current pilot site evaluation outcomes, when available, with NICE to ensure findings are considered in the development of future guidance.

What discussions he has had with social media companies on moderating (a) pro–eating disorder material and (b) misinformation relating to (i) diabetes and (ii) body image.

No discussions have been held with social media companies by the Department.Under the Government’s Online Safety Act, all in-scope services are now required to protect their users from illegal content, and platforms likely to be accessed by children need to prevent their users from accessing eating disorder content.We are working closely with the Department for Science, Innovation and Technology, Ofcom and others as the Online Safety Act takes effect. This includes exploring further opportunities to address harmful pro-eating disorder material and misinformation shared on social media and websites.

What assessment his Department has made of the potential merits of creating a national framework that includes risk screening tools for use in clinical practice to help prevent Type 1 Diabetes and Eating Disorders (T1DE).

NHS England is currently funding five Type 1 Disordered Eating (T1DE) pilots, with the aim of increasing understanding of the characteristics and care needs of people with T1DE, assessing the feasibility of the service delivery model and build the evidence base for an integrated diabetes and mental health pathway.Pilot sites are delivering a national high level service specification alongside testing local novel approaches to improving care including to awareness raising of the condition amongst both diabetes and eating disorder health care professionals.A national evaluation is currently underway to assess the impact of the five current pilot services. NHS England will review the evaluation findings to understand further opportunities to promote awareness of T1DE amongst healthcare professionals.NHS England works alongside its partners to support the delivery of key messages around diabetes education and awareness. This includes through a digital diabetes platform which is developing educational resources for T1DE.No assessment has been made of the merits of creating a national framework.

What assessment his Department has made of the potential impact of the planned termination of the Minor Eye Conditions Service in Coventry and Warwickshire from 1 November 2025 on (a) GP workloads, (b) A&E workloads, (c) patient outcomes and (d) meeting the objectives of the NHS Long Term Plan to (i) expand community-based care and (ii) reduce unnecessary hospital attendances.

The responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate National Health Service commissioner. All service changes should be based on clear evidence that they will deliver better outcomes for patients.