Written questions by Vickers.

How much funding his Department has allocated to support the (a) development and (b) expansion of MND clinical trial infrastructure.

The Department funds health and care research infrastructure through the National Institute for Health and Care Research (NIHR). This provides world-class research expertise, specialist facilities, a dedicated research delivery workforce, and support services across the National Health Service and wider health and care system in England.NIHR infrastructure funding is not allocated by individual disease or therapy area. Instead, it underpins the development and expansion of research capacity across all specialties, including motor neurone disease (MND). Examples include:- Biomedical Research Centres (BRCs), with £909 million awarded from December 2022 to March 2028. Six BRCs conduct research into neurological disease, supporting discovery science and the development of new trial approaches;- the Research Delivery Network, with approximately £380 million provided each year, providing the NHS with support funding and the workforce to expand research delivery capability across regions, including for MND studies; and- Clinical Research Facilities, with £214 million invested until 2029 in 28 facilities, creating dedicated spaces for early-phase and complex trials such as drug, cell, and gene therapies, supporting both the development and expansion of MND clinical trials.Government responsibility for MND research is shared between the Department of Health and Social Care, with research delivered by NIHR, and the Department for Science, Innovation and Technology, with research delivered by UK Research and Innovation (UKRI). In addition, targeted investments are helping to strengthen trial capacity, including £6 million for the MND Translational Accelerator, which connects UK institutes to speed up the development of treatments, and £8 million for the EXPERTS-ALS programme, which screens promising drugs and complements the MND-SMART platform trial.

What assessment he has made of the potential impact of limited trial site locations on the ability of motor neurone disease patients to participate in research; and what support his Department provides to help patients who need to travel significant distances to access trials.

The National Institute for Health and Care Research (NIHR), funded by the Department, supports patients and the public to take part in high-quality research. In 2024/25, the NIHR Research Delivery Network supported 35 motor neurone disease (MND) studies and recruited over 2,900 participants.We recognise that MND trials are often concentrated in specialist centres, which can create challenges for patients who live far from these sites. To address this, NHS England and the NIHR provide practical support to reduce travel barriers. The Healthcare Travel Costs Scheme enables eligible patients to claim travel expenses for National Health Service appointments, including research visits, while many trial sponsors and sites reimburse travel, accommodation, and subsistence costs. NIHR Clinical Research Facilities and the NIHR Research Delivery Network also provide logistical support to facilitate participation.In line with the NHS 10-Year Plan, there is a growing emphasis on delivering research in community and home settings, supported by digital tools and mobile research teams.

What discussions his Department has had with (a) NHS England and (b) the National Institute for Health and Care Research on (i) expanding the number of recruiting sites for and (ii) including James Cook University Hospital in Middlesbrough in the MND-SMART trial.

Decisions on site selection for clinical trials rest with the study sponsor, shaped by the design and requirements of the trial.No discussions about the MND-SMART trial have been held with the Department. However, while we are not directly involved in these decisions, the Department works through the National Institute for Health and Care Research (NIHR) to ensure a fair and transparent process for site identification.The NIHR’s United Kingdom-wide site identification service enables National Health Service organisations, including the James Cook University Hospital in Middlesbrough, to express interest and suitability to host research. This provides an inclusive and transparent process that ensures opportunities are shared equitably across the country, with decisions guided by the real-time capacity and capability of sites.The Department is committed to ensuring that all patients, including those with motor neurone disease, have access to cutting-edge clinical trials and innovative, lifesaving treatments.

What plans he has for (a) Admiral Nurses and (b) other dementia specialist nurses in the delivery of the proposed neighbourhood health service.

The Neighbourhood Health Service will bring together teams of professionals closer to people’s homes to work together to provide comprehensive care in the community. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, and so they could include dementia specialist nurses. While we will be clear on the outcomes we expect, we will give significant licence to tailor the approach to local need. While the focus on personalised, coordinated care will be consistent, services may look different in rural communities, coastal towns, or deprived inner cities.Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We would expect ICBs to commission services, which may include dementia specialist nurses/admiral nurses, based on local population needs, taking account of the National Institute for Health and Care Excellence’s (NICE) guidelines. NICE recommends providing people living with dementia with a single named health or social care professional who is responsible for coordinating their care.Under the 10-year plan, those living with dementia will benefit from improved care planning and better services.  We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.

Whether he has had recent discussions with local authorities on health inequalities in Stockton-on-Tees.

The United Kingdom faces significant health inequalities, with life expectancy and healthy life expectancy varying widely across and between communities. The Government is committed to building a fairer Britain, to ensure people can live well for longer, and spend less time in ill health, regardless of where they are born or their financial circumstances.The Department’s Office of Health Inequalities and Disparities North East and Yorkshire Regional Team collaborates with partners to provide system leadership for public health and to reduce health inequalities. The team facilitates the delivery of national and local public health priorities, providing expert advice. It also works with directors of public health in local authorities, integrated care systems, mayoral combined authorities, NHS England, and the wider National Health Service.North East local authorities received a total of £256 million in Public Health Grant funding for 2025/26, of which Stockton on Tees received £16.762 million. This funding provides services such as stop smoking, drug and alcohol treatment, health visiting/school nursing, and sexual health, among others, all of which contribute to addressing health inequalities.The Tees Valley Combined Authority also works to secure investment, create jobs, and grow the economy, helping to create the conditions in which health inequalities can be reduced.

What support is available for people with coeliac disease in areas where gluten-free prescriptions have been reduced or withdrawn.

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, to ensure consistency of approaches between ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practices.NHS England’s guidance on Prescribing Gluten-Free Foods in Primary Care states that commissioners restrict the prescribing of gluten free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end the prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.

What steps he is taking to monitor the affordability of gluten-free staple foods for people with coeliac disease.

The Department carried out an analysis of this issue as part of its Equalities Impact Assessment, which was published as part of the consultation on the availability of gluten-free (GF) foods on prescription in primary care, launched in March 2017. A copy of the Equality Impact Assessment following this consultation is available on the consultation page, at the following link:https://www.gov.uk/government/consultations/availability-of-gluten-free-foods-on-nhs-prescriptionWe looked at the equality impact assessment and the consultation responses, and as a result made the decision to retain GF bread and mixes on National Health Service prescription services. This will help coeliacs to obtain their basic food needs and will mitigate the risk that those on lower incomes are not able to purchase their own GF foods from retail outlets, where evidence shows that the price is often higher and availability more limited.In England, NHS prescription charge exemptions are in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.We have frozen NHS prescription charges in England for the first time in three years, keeping the cost of a prescription below £10. This decision will help with the cost of living for millions of patients who regularly pay for prescriptions.Consumer food prices depend on a range of factors, including import prices, domestic agricultural prices, domestic labour and manufacturing costs, and exchange rates. The Department for Environment, Food and Rural Affairs regularly engages with supermarkets and producers on a range of food supply matters. However, it is not for the Government to set retail food prices or to comment on day-to-day commercial decisions taken by businesses.

What steps he is taking to ensure that people diagnosed with coeliac disease have equitable regional access to gluten-free staple foods.

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, to ensure consistency of approaches between ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practices.NHS England’s guidance on Prescribing Gluten-Free Foods in Primary Care states that commissioners restrict the prescribing of gluten free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end the prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.

What steps he is taking to share best practice between (a) Integrated Care Boards that continue to provide gluten-free staple foods on prescription and (b) those that do not.

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, to ensure consistency of approaches between ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practices.NHS England’s guidance on Prescribing Gluten-Free Foods in Primary Care states that commissioners restrict the prescribing of gluten free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end the prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.

What recent estimate he has made of the number of unfilled NHS roles in the North East.

NHS England publishes a compendium of NHS Vacancy Statistics each quarter. The information currently provides four measures of the level of vacancies in the National Health Service, one of which presents management information collected by NHS England from NHS trusts on full time equivalent vacancies reported, which is the most commonly used measure. NHS England collects and publishes vacancies in the North East and Yorkshire as a single region, which is available in this publication.Published vacancy data, including information on the definition of the collected data and the available timeseries, along with the measure’s strengths and weaknesses, is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey

What assessment he has made of the potential impact of Integrated Care Board decisions to reduce or withdraw gluten-free prescribing on patient health outcomes for people with coeliac disease.

The Department carried out an analysis of this issue as part of its Equalities Impact Assessment, which was published as part of the consultation on the availability of gluten-free (GF) foods on prescription in primary care, launched in March 2017. A copy of the Equality Impact Assessment following this consultation is available on the consultation page, at the following link:https://www.gov.uk/government/consultations/availability-of-gluten-free-foods-on-nhs-prescriptionWe looked at the equality impact assessment and the consultation responses, and as a result made the decision to retain GF bread and mixes on National Health Service prescription services. This will help coeliacs to obtain their basic food needs and will mitigate the risk that those on lower incomes are not able to purchase their own GF foods from retail outlets, where evidence shows that the price is often higher and availability more limited.In England, NHS prescription charge exemptions are in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.We have frozen NHS prescription charges in England for the first time in three years, keeping the cost of a prescription below £10. This decision will help with the cost of living for millions of patients who regularly pay for prescriptions.Consumer food prices depend on a range of factors, including import prices, domestic agricultural prices, domestic labour and manufacturing costs, and exchange rates. The Department for Environment, Food and Rural Affairs regularly engages with supermarkets and producers on a range of food supply matters. However, it is not for the Government to set retail food prices or to comment on day-to-day commercial decisions taken by businesses.

What assessment he has made of the potential impact of increases to the cost-of-living on the ability of people with coeliac disease to maintain a medically required gluten-free diet.

The Department carried out an analysis of this issue as part of its Equalities Impact Assessment, which was published as part of the consultation on the availability of gluten-free (GF) foods on prescription in primary care, launched in March 2017. A copy of the Equality Impact Assessment following this consultation is available on the consultation page, at the following link:https://www.gov.uk/government/consultations/availability-of-gluten-free-foods-on-nhs-prescriptionWe looked at the equality impact assessment and the consultation responses, and as a result made the decision to retain GF bread and mixes on National Health Service prescription services. This will help coeliacs to obtain their basic food needs and will mitigate the risk that those on lower incomes are not able to purchase their own GF foods from retail outlets, where evidence shows that the price is often higher and availability more limited.In England, NHS prescription charge exemptions are in place to help those with the greatest need. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, or whether they are in receipt of certain benefits or a war pension.We have frozen NHS prescription charges in England for the first time in three years, keeping the cost of a prescription below £10. This decision will help with the cost of living for millions of patients who regularly pay for prescriptions.Consumer food prices depend on a range of factors, including import prices, domestic agricultural prices, domestic labour and manufacturing costs, and exchange rates. The Department for Environment, Food and Rural Affairs regularly engages with supermarkets and producers on a range of food supply matters. However, it is not for the Government to set retail food prices or to comment on day-to-day commercial decisions taken by businesses.

What recent assessment he has made of cancer (a) referral and (b) diagnosis rates in Tees Valley.

Cancer patients are waiting too long for diagnosis and treatment on the NHS, including in Tees Valley. It is crucial that patients with cancer have access to treatment as quickly as possible after their diagnosis.The NHS is working with local providers to identify opportunities in both community diagnostic centres and hospital based diagnostic services to improve performance against the Faster Diagnosis Standard, to reduce the number of patients waiting too long for a confirmed diagnosis of cancer.

What steps eh has taken to ensure that Integrated Care Boards comply with national guidance on prescribing gluten-free products to patients with coeliac disease.

Decisions about the commissioning and funding of local health services are the responsibility of local integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, to ensure consistency of approaches between ICBs. NHS England’s guidance should be taken into account when ICBs formulate local policies, and prescribers are expected to reflect local policies in their prescribing practices.NHS England’s guidance on Prescribing Gluten-Free Foods in Primary Care states that commissioners restrict the prescribing of gluten free (GF) foods to bread and mixes only. Under the current legislation, ICBs may choose to further restrict product choice, or end the prescribing of GF foods altogether, if they feel this is appropriate for their population, whilst taking account of their legal duties to advance equality and having regard to reducing health inequalities.The national prescribing position in England remains that GF bread and mixes can be provided to coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in part XV of the Drug Tariff. This means that prescribers can issue NHS prescriptions, based on a shared decision between prescriber and patient, while also being mindful of local and national guidance.

What steps he is taking to increase training placements for (a) nurses and (b) allied health professionals in the North East.

Clinical practice placements are mandatory for healthcare education and training, in order to support and embed the skills, values, and behaviours for the future National Health Service workforce. Financial support is currently available to placement providers in the form of a placement tariff for nurses and allied health professionals.As part of our 10-Yeah Health Plan, we have committed to reforming the clinical placement tariff system to ensure it drives clinical placement activity in the right professions and settings.The Professional Strategy for Nursing and Midwifery, being developed by the Chief Nursing Officer for England, will build on this to ensure that every nursing student spends sufficient time across a range of clinical settings, and will include a requirement for all students to have a high-quality experience in neighbourhood and community settings and social care.

What assessment he has made of the potential impact of workforce shortages on ambulance response times in rural areas of the North East.

North East Ambulance Service (NEAS) is fully staffed at present across their patient-facing roles in emergency care. When vacancies arise, recruitment is targeted in those areas. The NEAS works closely with universities to support the 3-year education programme for paramedics so when jobs are available, they are encouraged to apply. NEAS will also, if required, use overtime, additional hours, bank shifts or local third-party providers should they have any short-term or unplanned shifts not covered to ensure response times and therefore patient care is not affected.The latest figures show that Category 2 response times in the North East were 20 minutes 51 seconds on average, the fastest in the country.

What recent progress he has made in digitising patient records in NHS trusts in Teesside.

University Hospitals Tees (UHT), comprising of the North Tees and Hartlepool and South Tees Hospitals NHS Foundation Trusts, continues to progress its ambitions in digitising patient records across Teesside, North Yorkshire, and County Durham.A recent digital patient record success for UHT was the achievement of the BSI0008:2020 accreditation. This means that the scanning bureau at the North Tees and Hartlepool NHS Foundation Trust now holds the accreditation equivalent to that of major national and international organisations for storing patient information electronically.

What steps he is taking to help support Integrated Care Boards to improve patient access in areas with high levels of deprivation.

Ensuring that funding for core services, provided via integrated care boards, are fairly allocated across practices nationwide is crucial and we recognise the importance of prioritising areas with high levels of deprivation. This is why we have committed to reviewing the general practice (GP) funding formula, so that resources are directed where they are needed most to improve patient access.Through our 10-Year Health Plan, it will be easier and faster to see a GP. We will end the 8:00am scramble for appointments, train more doctors, and will guarantee consultations within 24 hours for those who need one. In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of 2,000 individual GPs into primary care networks across England, helping to increase appointment availability and improve care for thousands of patients. The new £102 million Primary Care Utilisation and Modernisation Fund will create additional clinical space within over 1,000 practices across England. This investment will deliver more appointments and improve patient care.

How many and what proportion of NHS estates are in need of (a) major repairs and (b) replacement in the North East.

National Health Service trusts are legally responsible for managing and maintaining their estates using their operational capital allocations, and as part of this, they regularly assess the physical condition of their estate.The NHS England Estates Related Information Collection (ERIC) survey collects data from trusts on the condition of their estate annually, including backlog maintenance, and the projected cost of bringing all the buildings on each NHS site into acceptable condition. The latest ERIC data, from 2023/24 and including trusts in the North East, is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/management-information---provisional-summary-figures-for-2023-24Repairing and rebuilding our NHS estate is a vital part of our ambition to create an NHS that is fit for the future through our 10-Year Health Plan. The Government’s recently published 10 Year Infrastructure Strategy set out ten-year maintenance budgets for the public estate, confirming £6 billion per year for the maintenance and repair of the NHS estate up to 2034/35.

What recent discussions he has had with Integrated Care Boards on the provision of gluten-free bread and flour mixes for patients diagnosed with coeliac disease.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not held any meetings with integrated care boards (ICBs) or patient groups on the provision of gluten free (GF) bread and flour mixes for patients diagnosed with coeliac disease.Following consultation, the legislation restricting the prescribing of GF foods to bread and mixes came into force in December 2018, and NHS England’s guidance on prescribing GF foods in primary care was subsequently issued to clinical commissioning groups, now ICBs. Following a review in 2019, the position in England remains that GF bread and mixes can be provided to all eligible coeliac patients on a National Health Service prescription, and a wide range of these items continue to be listed in Part XV of the Drug Tariff. NHS England currently has no plans to update the guidance.