Written questions by Wrigley.

If his Department will work with Versus Arthritis to (a) bring down waiting times for people with arthritis and (b) support them while waiting for treatment.

On 6 January 2025, NHS England published the new Elective Reform Plan, which sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament.Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their populations, including for those with arthritis. To support this, the Department of Health and Social Care is delivering the Getting It Right First Time (GIRFT) Musculoskeletal (MSK) Community Delivery Programme jointly with NHS England and the Department for Work and Pensions. With a £3.5 million funding boost, GIRFT will work with the ICBs to reduce MSK community waiting times.The Department funds research into MSK conditions, including arthritis, through the National Institute for Health and Care Research (NIHR). Through that route, the Department spent approximately £26.3 million on MSK research in 2023/24, and £79.2 million since 2019/20. In particular, the Leeds Biomedical Research Centre aims to improve treatment for osteoarthritis. The NIHR, in collaboration with Versus Arthritis, also funds a dedicated UK MSK Translational Research Collaboration, aligning investment in MSK translational research and creating a United Kingdom-wide ambition and focus to drive cutting edge research and improve outcomes for patients.The GIRFT programme in NHS England has had a paediatric rheumatology workstream since April 2024. The team has assembled the largest ever set of data and information about paediatric rheumatology in England and is visiting every department in England to discuss its findings. It will produce its national report with recommendations later this financial year. This will include a focus on supporting young people and their parents as they transition to adult services.The GIRFT team will be working with the British Society for Rheumatology and rheumatology departments in England to implement the findings and recommendations of the GIRFT paediatric rheumatology national report.NHS England Specialised Commissioning has a Clinical Reference Group for specialised paediatric rheumatology, which has produced a service specification naming juvenile idiopathic arthritis as one of the conditions that should be managed by a specialist paediatric rheumatology team. The service specification also sets out that specialised paediatric rheumatology teams will provide transitional care to facilitate transfer to, and ongoing care in, adult rheumatology. Specialised paediatric rheumatology services are expected to be commissioned in line with this service specification.The Department will continue to work with Versus Arthritis as we consider how best to provide National Health Services for people with MSK conditions such as arthritis.

Pursuant to the Answer of 1 April 2025 to Question 41578 on Nurses: Training, if he will take steps to increase the number of nursing positions in Devon.

Decisions about the number of nursing positions in Devon are a matter for individual National Health Service trusts. NHS trusts manage their recruitment at a local level to ensure they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade and treat patients on time again.

What information his Department holds on the number and proportion of nurses on a bursary unable to find nursing jobs after graduating.

The Department does not hold the information requested.

If he will make an assessment of the potential merits of implementing the Parkinson's UK Parky Charter.

We acknowledge the challenges that neurology services have been facing, particularly regarding the workforce, delays to treatment and care, and the lack of information and support that some patients have experienced. However, whilst no assessment has been made on the potential merits of the Parkinson’s UK Parky Charter, I am pleased that there are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease. These national initiatives include the RightCare Progressive Neurological Conditions Toolkit, the Getting It Right First Time Programme for Neurology, and the Neurology Transformation Programme, a multi-year, clinically led programme to develop a new model of integrated care for neurology services. Furthermore, we have delivered an additional two million appointments between July and November 2024 compared to the same period in 2023, seven months ahead of schedule, as a first step in our commitment to ensuring patients can expect to be treated within 18 weeks. These additional appointments have taken place across a number of specialities, including neurology. This summer, we will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade and treat patients, including those with Parkinson’s, 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. Approximately 89% of prescription items are currently dispensed free of charge, and there are a wide range of exemptions from prescription charges already in place. People with Parkinson’s who are 60 years old or over are entitled to free prescriptions. For those that have to pay for prescriptions, the cost can be capped by purchasing a pre-payment certificate. Additionally, the NHS Low Income Scheme can provide help with health costs on an income-related basis. The Government spent £79.06 million on research into Parkinson’s between 2019/20 and 2023/24, with research delivered via UK Research and Innovation and the National Institute for Health and Care Research, and is continuing to invest in Parkinson’s disease research.

Pursuant to the Answer of 17 March 2025 to Question 36892 on Prostate Cancer: Health Services, if he will make an assessment of the adequacy of the (a) time taken and (b) effectiveness of treatment delivered for patents diagnosed with prostate cancer in Devon.

Routine Prostate Specific Antigen (PSA) testing is not offered on the National Health Service, although men aged 50 years old or over can ask their general practitioner for a PSA test, even if they do not have symptoms. This applies to anyone aged 50 years old or over in any part of England.The NHS England Cancer Programme has commissioned clinical cancer audits, including for prostate cancer, which provide timely evidence for cancer service providers of where patterns of care in England may vary. These audits will help NHS England understand where to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The audits are ongoing and will act on their findings in due course.However, we recognise that patients are often waiting longer than they should for cancer treatment and services. The National Cancer Plan will highlight how we will improve diagnosis rates and the effectiveness of treatment for people across England, including in Devon.

Pursuant to the Answer of 17 March 2025 to Question 36892 on Prostate Cancer: Health Services, if he will take steps to provide (a) faster and (b) wider availability for prostate-specific antigen tests in Devon.

Routine Prostate Specific Antigen (PSA) testing is not offered on the National Health Service, although men aged 50 years old or over can ask their general practitioner for a PSA test, even if they do not have symptoms. This applies to anyone aged 50 years old or over in any part of England.The NHS England Cancer Programme has commissioned clinical cancer audits, including for prostate cancer, which provide timely evidence for cancer service providers of where patterns of care in England may vary. These audits will help NHS England understand where to increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The audits are ongoing and will act on their findings in due course.However, we recognise that patients are often waiting longer than they should for cancer treatment and services. The National Cancer Plan will highlight how we will improve diagnosis rates and the effectiveness of treatment for people across England, including in Devon.

What assessment his Department has made of the potential impact of ending enhanced payments for NHS nurses covering staff shortages on staffing levels at (a) Royal Devon and Exeter Hospital, (b) North Devon District Hospital and (c) Torbay Hospital.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This 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.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What steps his Department is taking to ensure that NHS nurses providing additional cover for staff shortages are adequately compensated.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This 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.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What steps his Department is taking to ensure that ending enhanced payments for NHS nurses covering staff shortages does not increase reliance on agency staff.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This 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.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What assessment his Department has made of the potential impact of ending enhanced payments for NHS nurses covering staff shortages on the finances of nurses; and what estimate his Department has made of the potential change in agency staffing costs of ending those payments.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This 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.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

If he will convene a stakeholder roundtable to help tackle the shortage of Pancreatic enzyme replacement therapy medication with (a) manufacturers, (b) patient advocacy groups and (c) other relevant stakeholders.

There are no current plans to convene such a roundtable. The Department is in regular discussion with the suppliers of pancreatic enzyme replacement therapy (PERT) on the latest stock availability and the actions that are being taken to mitigate the supply issue that is affecting the whole of the United Kingdom. Through these discussions, we have managed to secure additional volumes for 2025 for the UK. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.In the longer term, the Department has had interest from non-UK suppliers of PERT wishing to bring their products to the UK and, along with colleagues in the Medicine and Healthcare products Regulatory Agency, we are working with these potential suppliers; if authorised these products could further diversify and strengthen the market. The Department will continue to meet with all suppliers to understand what more can be done to add further resilience to the UK market.In December 2024, the Department issued additional management advice to healthcare professionals. This directs clinicians to consider the unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented.The Department meets regularly with the affected patient advocacy groups and charities to ensure they are kept informed on the latest supply picture and any communications issued.The Department will continue collaboration with clinicians and representatives from the impacted patient advocacy groups and charities so that they are informed on the supply situation and the mitigation actions being taken.

What estimate he has made of levels of funding available to GPs following (a) the new GP contract for 2025-26 and (b) changes to employer National Insurance contributions.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025. Primary care providers, including general practices, are valued independent contractors who provide almost £20 billion worth of services in the National Health Service. Each year, we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract. We are investing an additional £889 million in general practice (GP) to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. We are pleased that the England general practitioners committee of the British Medical Association is supportive of the contract changes.

What assessment he has made of the potential impact of changes to employer National Insurance contributions on the new GP contract.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025. Primary care providers, including general practices, are valued independent contractors who provide almost £20 billion worth of services in the National Health Service. Each year, we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract. We are investing an additional £889 million in general practice (GP) to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. We are pleased that the England general practitioners committee of the British Medical Association is supportive of the contract changes.

What steps his Department is taking to ensure that people with an early prostate cancer diagnosis can quickly access (a) treatment and (b) care.

Improving access to treatment and care are key priorities for the Government for all cancer types, including prostate cancer.To achieve this, we have delivered an extra 40,000 operations, scans, and appointments each week, during our first year in Government as the first step to ensuring early diagnosis and faster treatment. Additionally, we will spend £70 million on new radiotherapy machines, to ensure the most advanced treatment is available to patients who need it.Our forthcoming National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as improving access to treatment and care.

If he will make an assessment of the potential merits of protecting the title of nurse in law.

The Government recognises that the protection in law of certain professional titles is important for public safety. Protecting a title provides assurance to the public that someone using that title is competent and safe to practise Although ‘registered nurse’ is a protected title, ‘nurse’ is currently not a protected title. The Government is aware of the concerns which this generates, along with the complications associated with protecting the nurse title, given that it is used in multiple professions; for example, registered nurses, dental nurses, school nurses and veterinary nurses. The Government will continue to work with the professional regulators, including the Nursing and Midwifery Council, as it considers its priorities for professional regulation and will set out its position shortly.

If he will take steps to ensure Quetiapine modified-release tablets are not in shortage for long.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

Whether he has had recent discussions with representatives from the pharmacy sector on the supply of Quetiapine modified-release tablets.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

If he will take steps to notify patients in need of Quetiapine modified-release tablets when the current shortage is expected to end.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

What assessment he has made of the potential impact of the supply shortage of Quetiapine modified-release tablets on patients.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

What steps he is taking to help patients with a (a) history and (b) risk of addiction; and if he will take steps to identify that risk before addictive medication is prescribed.

The government is committed to supporting those most vulnerable to experiencing harms from drugs and alcohol, and ensure they are supported to live healthier lives for longer. We are committed to ensuring that anyone with an illicit drug or alcohol dependency can access the help and support they need through evidence-based and high-quality treatment and recovery services. The Department funds local authorities to deliver drug and alcohol treatment services through the Public Health Grant (PHG). In addition to the PHG, the Department allocated local authorities £267 million in 2024/25 to improve the quality and capacity of drug and alcohol treatment and recovery. When prescribing medication, clinicians are expected to work with patients to make decisions about their care and treatment as part of shared decision-making, including discussing risks, benefits, and possible consequences of different options through information-sharing.