Written questions by Perteghella.

If his Department will issue guidance to (a) GP practices and (b) Integrated Care Boards on shared care agreements for ADHD patients diagnosed privately in line with NICE guidelines.

General practitioners (GPs) are independent contractors that provide services within the National Health Service. The General Medical Council (GMC) has published the guidance, Good practice in proposing, prescribing, providing and managing medicines and devices content. This includes guidance on shared care arrangements between a specialist service and the patient’s GP to help GPs decide whether to accept shared care responsibilities for any condition. The guidance is available at the following link:https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-careNHS clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. The British Medical Association has issued guidance, underpinned by the GMC guidance, which outlines that shared care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared care may be appropriate where private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place. All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and 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; this applies to both NHS and private medical care.We are supporting a cross-sector taskforce that NHS England has established to look at attention deficit hyperactivity disorder (ADHD) service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the NHS, education and justice, to better understand the challenges affecting people with ADHD including timely access to services and support.

What steps is he taking to ensure that individuals diagnosed with ADHD by private specialists can access NHS treatment.

General practitioners (GPs) are independent contractors that provide services within the National Health Service. The General Medical Council (GMC) has published the guidance, Good practice in proposing, prescribing, providing and managing medicines and devices content. This includes guidance on shared care arrangements between a specialist service and the patient’s GP to help GPs decide whether to accept shared care responsibilities for any condition. The guidance is available at the following link:https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-careNHS clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. The British Medical Association has issued guidance, underpinned by the GMC guidance, which outlines that shared care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared care may be appropriate where private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place. All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and 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; this applies to both NHS and private medical care.We are supporting a cross-sector taskforce that NHS England has established to look at attention deficit hyperactivity disorder (ADHD) service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the NHS, education and justice, to better understand the challenges affecting people with ADHD including timely access to services and support.

What assessment his Department has made of the effectiveness of measures in place to prevent violence against NHS staff.

Individual employers are responsible for the health and safety of their staff, and they put in place many measures to ensure their health and safety, including appropriate security, training, and emotional support for staff affected by violence.To support them, NHS England is working on initiatives to prevent and reduce violence and aggression from patients, their families, and the public. In December 2024, NHS England updated its violence prevention standard. This sets out guidance for employers to help them identify risks and develop local policies for dealing with violence and supporting staff.

What steps he is taking to improve preparedness for first-time anaphylaxis incidents in rural communities.

In November 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Commission on Human Medicine’s Adrenaline Auto-injector Expert Working Group, with wide-ranging input from patient groups, leading allergy experts and healthcare professionals, published a report which outlined recommendations for the safe and effective use of adrenaline auto-injectors (AAIs), including quicker treatment, to help save lives. MHRA has worked alongside the Department and the wider health system to take forward these recommendations, some of which are already in place.In June 2023, MHRA, with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and provide advice on the use of AAIs. MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs. Alongside this, MHRA produced guidance, which states that prescribers should prescribe two AAIs to make sure patients always have the second dose and that those who are prescribed AAIs should carry two AAIs at all times.The National Institute for Health and Care Excellence has also produced guidance on assessment and referral for anaphylaxis. It aims to improve the quality of care for people with suspected anaphylaxis by detailing the assessments that are needed and recommending referral to specialist allergy services after emergency treatment.Most community pharmacies offer vaccinations. As part of offering this service, pharmacy contractors are expected to recognise and treat anaphylaxis. They must have immediate access to an anaphylaxis pack, including adrenaline. They are required to undertake training to administer adrenaline from an ampoule using a needle and AAIs in case of anaphylactic reactions.Data regarding all anaphylaxis-related deaths in England and Wales are documented by the Office for National Statistics, and the British Society for Allergy and Clinical Immunology also holds a register to capture and learn fatal cases of anaphylaxis which has been operational since 1992, the UK Fatal Anaphylaxis Register (UKFAR).Regarding the reporting of anaphylaxis in hospitals, NHS England’s National Patient Safety Team is working with the UKFAR to develop a mechanism for sharing relevant patient safety anaphylaxis incidents. The aim will be for the UKFAR to extract and share patient safety incidents reported to the national databases, the National Reporting and Learning System and Learn from Patient Safety Events, relating to severe allergic reactions.

Whether adrenaline auto-injectors are routinely carried by first responders.

Regulation 238 of the Human Medicines Regulations 2012 provides an exemption from certain requirements related to the administration of medicines and allows administration of adrenaline for the purpose of saving a life in an emergency. The provision under Regulation 238 should be reserved only for exceptional circumstances that could not have been foreseen.In November 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Commission on Human Medicine’s Adrenaline Auto-injector Expert Working Group, with wide-ranging input from patient groups, leading allergy experts and healthcare professionals, published a report which outlined recommendations for the safe and effective use of adrenaline auto-injectors (AAIs), including quicker treatment, to help save lives. MHRA has worked alongside the Department and wider health system to take forward these recommendations, some of which are already in place.In June 2023, MHRA, with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and provide advice on the use of AAIs. MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs. Alongside this, MHRA produced guidance, which states that prescribers should prescribe two AAIs to make sure patients always have the second dose and that those who are prescribed AAIs should carry two AAIs at all times.Ambulance staff are trained in how to treat a range of conditions, including anaphylaxis. Treatment options may include a dose of adrenalin via a syringe or use of AAIs.A public consultation would be needed before a decision can be made on the wider availability of AAIs in public places, including with first aid organisations, together with legislative change.The Community First Responder (CFR) programme enables volunteers trained by the ambulance service to attend certain types of emergency calls in the area where they live or work. CFRs have had first aid training but are not medically trained. CFRs are trained in the administration of a patient’s own AAI, which would ensure the correct medication and dose for that patient. In general, CFRs do not carry medication.

What steps he is taking to increase the number of (a) NHS dentists and (b) NHS dental appointments in Stratford-on-Avon constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Stratford-on-Avon constituency, this is the NHS Coventry and Warwickshire ICB.

What steps he is taking to improve waiting times to access dementia treatment in Warwickshire.

Coventry and Warwickshire ICS have a number of initiatives aimed at increasing capacity for dementia assessment and treatment, particularly in South Warwickshire where it is recognised that there are longer delays.An additional consultant and team have been in place in South Warwickshire since September 2024 to run intensive clinics, increasing assessment and treatment capacity and speed.In November 2024, South Warwickshire added additional weekend dementia clinics.The Memory Service in Warwickshire have introduced a range of measures to maximise specialist staff capacity, including employing additional administrative staff to complete tasks not requiring a specialist clinician. October 2024 saw a 40% increase in number of assessments completed by the team compared to the average earlier this year, and a 59% increase in reviews of existing patients.

If he will commit funding for research into glioblastoma brain tumours.

Research is crucial in tackling cancer, which is why the Department spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer being the largest area of spend, at over £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group, reflecting its high priority.In the five years between 2018/19 and 2022/23, the NIHR spent over £11.3 million on research projects focussed on brain tumours. In addition, our wider investments in NIHR research infrastructure, including facilities, services, and the research workforce, further allows us to leverage research funding from other donors and organisations. These investments are estimated to be £31.5 million, between 2018/19 and 2022/23, and have enabled 227 brain cancer research studies to take place in the same period.Brain cancer remains one of the hardest to treat cancers in both adults and children and we urgently need more research to inform our efforts, which is why in September the NIHR announced new research funding opportunities for brain cancer research, spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients, and a new funding call to generate high quality evidence in brain tumour care, support, and rehabilitation. Further information is available at the following link:https://www.nihr.ac.uk/news/new-funding-opportunities-novel-brain-tumour-research-launchedWe are committed to furthering our investment and support for high-quality brain tumour research, ensuring that the funding is used in the most meaningful and impactful way.

Whether he plans to reform the funding model for charitable hospices as part of the 10 year plan for health and social care.

We have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future, by driving three shifts in the way health care is delivered, specifically: moving healthcare from hospital to the community; from analogue to digital; and from sickness to prevention. We will carefully consider policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders, including those in the hospice sector, as we develop the plan.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services.  The amount of funding charitable hospices receive varies by integrated care board (ICB) area, and will, in part, be dependent on the breadth of palliative and end of life care provision within each ICB catchment area.I recently met with NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care in England.  We will consider next steps on palliative and end of life care, including hospice funding, in the coming months.