Written questions by Vickers.

What steps he is taking to improve the retention of social care workers in areas with a high rate of vacancies.

English local authorities have responsibility under the Care Act 2014 to meet social care needs, and statutory guidance directs them to ensure there is sufficient workforce in adult social care. Skills for Care data suggests the adult social care workforce is growing. Skills for Care data shows in 2024/25 there were 1.6 million filled posts, an increase of 52,000, or 3.4%, from 2023/24. Skills for Care data also shows that the turnover rate decreased from 25.8% in 2023/24 to 24.7% in 2024/25 in the independent sector. The Government is committed to a well-supported adult social care workforce who are recognised as the professionals they are. Those with the opportunity to develop and progress in their role are far more likely to remain within the adult social care workforce. That is why we are delivering an ambitious programme of reforms with the aim of attracting people to join and remain in the sector, help professionalise the workforce, and improve the quality and experience of those receiving care. These include delivering the first universal career structure for the whole adult social care sector, a Learning and Development Support Scheme backed by up to £12 million funding in 2025/26, and introducing a Fair Pay Agreement.

Whether he plans to include specialist assessments by dementia nurses as standard evidence in NHS Continuing Healthcare eligibility decisions.

There are no plans to update NHS Continuing Healthcare (CHC) guidance regarding mobility assessments or specialist assessments by dementia nurses. The CHC assessment process is supported by the Decision Support Tool. This provides practitioners with a way to bring together and record an individual’s needs in the twelve ‘care domains’, including mobility. The assessment should consider the ways in which an individual’s needs interact with one another, for example how cognition impacts on mobility.Eligibility for CHC is not determined by diagnosis or condition but is assessed on a case-by-case basis considering the totality of an individual’s needs, ensuring a person-centred approach. Someone with specialist knowledge of an individual’s condition, for example dementia, should be involved in the process. Assessments should take into account evidence from a comprehensive range of assessments relating to the individual. For individuals with dementia, this could include specialist assessments by dementia nurses.

What discussions he has had with (a) Coeliac UK and (b) other patient representative groups on access to gluten-free staple products in England.

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.

What steps his Department is taking to improve access to NHS Continuing Healthcare for people with (a) young onset dementia and (b) other forms of dementia.

Our national statutory guidance, the National framework for NHS Continuing Healthcare and NHS-funded Nursing Care, outlines that access to NHS Continuing Healthcare (CHC) assessment, care provision, and support should be fair, consistent, and free from discrimination. This national statutory guidance is available at the following link:https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-careEligibility for CHC is not determined by diagnosis or condition. Individuals can be identified and referred for CHC assessments by a variety of health or social care practitioners who have been trained and are known to the individual. Individuals and families can also request a CHC assessment from a health and care practitioner.Integrated care boards should make the CHC Public Information Leaflet available to members of the public, for example through local National Health Service websites, hard copies on hospital wards, through primary care outlets, local care homes, and local voluntary sector organisations. This Public Information Leaflet containing further information on CHC is available at the following link:https://www.gov.uk/government/publications/nhs-continuing-healthcare-and-nhs-funded-nursing-care-public-information-leaflet/public-information-leaflet-nhs-continuing-healthcare-and-nhs-funded-nursing-care--2NHS England has also commissioned an information and advice service for CHC, supplied by Beacon, which individuals and their families might find helpful, and which is available at the following link:https://beaconchc.co.uk/how-we-can-help/free-information-and-advice-on-nhs-continuing-healthcare/

How much funding his Department has allocated to community mental health transformation programmes in the North East since 2022.

The following table shows the funding allocated to community mental health transformation programmes in the North East and North Cumbria Integrated Care Board area:YearAllocated Funding2022/23£17.4 million2023/24£21.7 million2024/25£22.1 millionSource: NHS EnglandNote: These figures represent service development funding directed at transformation and do not represent the total amount allocated to community mental health services in the area.

What funding has been allocated to support mental health crisis response services in the Tees Valley since 2021.

The following table shows the nationally allocated funding to support mental health crisis response services in the Tees Valley area:YearAllocated Funding (,000)2023/24£8442024/25£8542025/26 (planned spend)£1,079Source: NHS England Notes:Information for 2021/22 and 2022/23 is not available.These figures represent service development funding directed at transformation and do not represent the total amount allocated to community mental health services in the area.

What steps he is taking to reduce elective care backlogs at hospitals in the North East.

As of May 2025, the latest available data, the total waiting list in the North East and Yorkshire region stood at 990,884, with 67.1% waiting within 18 weeks, which is better than the national average of 60.9%.Since May 2024, the waiting list in North East and Yorkshire region has decreased by 19,141, and 18-week performance has improved by 1.7%. The North East and Yorkshire region includes:Humber and North Yorkshire Integrated Care Board (ICB);North East and North Cumbria​ ICB;South Yorkshire ICB; andWest Yorkshire ICB.We have committed to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment by March 2029. There are a range of efforts underway, nationally and in the North East, to reduce the time patients are waiting for elective care.The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts we will undertake to return to the 18-week standard, and to ensure patients have the best possible experience while they wait. This includes addressing the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce elective and cancer waits.We have supported this with additional investment in the autumn and spring Spending Reviews, which has allowed us to exceed our pledge to deliver an extra two million operations, scans, and appointments, having now delivered 4.6 million additional appointments up to the end of April 2025.Furthermore, in the 10-Year Health Plan, the Department has set out a transformed vision for elective care by 2035, where the majority of interactions no longer take place in a hospital building, instead happening virtually or via neighbourhood services. Planned care will be more efficient, timely, and effective.

What recent assessment he has made of the adequacy of NHS dentistry provision in (a) Stockton and (b) the Tees Valley.

Dental Statistics - England 2023/24, published by the NHS Business Services Authority on 22 August 2024, is available at the following link:https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202324The data for the North East and North Cumbria Integrated Care Board (ICB), which includes Stockton and the Tees Valley, shows that 45% of adults were seen by a National Health Service dentist in the previous 24 months up to June 2024, compared to 40% in England, and that 58% of children were seen by an NHS dentist in the previous 12 months up to June 2024, compared to 56% in England.We will deliver 700,000 extra urgent dental appointments per year, and ICBs have been making extra appointments available from 1 April 2025. The North East and North Cumbria ICB is expected to deliver 57,559 additional urgent dental appointments as part of the scheme.We are committed to reforming the dental contract, with a shift to focus on prevention and the retention of NHS dentists.

For what reason NHS England awarded only three contracts for the provision of hyperbaric oxygen therapy services following its most recent tendering process.

NHS England is committed to ensuring equitably accessible, high-quality services, for anyone who requires hyperbaric oxygen therapy (HBOT). This will be achieved through the commissioning of six geographically dispersed services across England. Three preferred providers have been identified to date, and a further procurement exercise will take place to identify the three remaining centres.The contract for HBOT services, also known as recompression, was reviewed in 2024, as existing contract terms expired. This included an update of the service specification using the published full methods process, and a public consultation on the proposal to reduce the number of commissioned providers in England from eight to six centres. Further information on the service specification, the published full methods process, and the consultation is available, respectively, at the following three links:https://www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdfhttps://www.england.nhs.uk/publication/methods-national-service-specifications/https://www.england.nhs.uk/long-read/reviewing-hyperbaric-oxygen-services-consultation-guide/#:~:text=Background-,Background,Manual%20of%20Prescribed%20Specialised%20ServicesThe updates to the specification seek to ensure timely access to treatment for the most acutely unwell patients with the specification requiring:the delivery of care that is integrated with other services, including the emergency department, critical care, and other healthcare professionals as required; andfacilities should be capable of receiving patients in any diagnostic category who may require advanced life support either immediately or during HBOT.The geographical scope of the six services will ensure that there are no more than four hours travelling time by road from coastal locations, from the furthest borders, or between neighbouring commissioned HBOT centres, which is in line with good practice guidelines.

How NHS England assessed (a) geographic coverage and (b) patient travel time in its hyperbaric oxygen therapy commissioning criteria; and how this was factored into final decisions.

The contract for hyperbaric oxygen therapy (HBOT) services, also known as recompression, was reviewed in 2024, as existing contract terms expired. This included an update of the service specification using the published full methods process, and a public consultation on the proposal to reduce the number of commissioned providers in England from eight to six centres. Further information on the service specification, the published full methods process, and the consultation is available, respectively, at the following three links:https://www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdfhttps://www.england.nhs.uk/publication/methods-national-service-specifications/https://www.england.nhs.uk/long-read/reviewing-hyperbaric-oxygen-services-consultation-guide/#:~:text=Background-,Background,Manual%20of%20Prescribed%20Specialised%20ServicesThe updates to the specification seek to ensure timely access to treatment for the most acutely unwell patients with the specification requiring:- the delivery of care that is integrated with other services, including the emergency department, critical care, and other healthcare professionals as required; and- facilities should be capable of receiving patients in any diagnostic category who may require advanced life support either immediately or during HBOT.The geographical scope of the six services will ensure that there are no more than four hours travelling time by road from coastal locations, from the furthest borders, or between neighbouring commissioned HBOT centres, which is in line with good practice guidelines.

What discussions NHS England had with (a) the coastguard,(b) ambulance trusts and (c) relevant statutory bodies before finalising the list of contracted hyperbaric oxygen therapy providers.

Last year, NHS England undertook stakeholder testing and a public consultation on the revised service specification for hyperbaric oxygen services. The main impact of the proposals was the reconfiguration of the number of commissioned hyperbaric oxygen therapy centres in England, from eight centres to six.The review was led by the chair of the Hyperbaric Oxygen Therapy Clinical Reference Group and the lead commissioner for the service, and was supported by a Specification Working Group (SWG). Membership of the SWG included a patient representative, clinical leads from current commissioned providers, consultants in public health, and members of the British Hyperbaric Association. Specialist advice was sought on relevant inter-dependent services including adult critical care, HM Coastguard, adult critical care transfer services, and children’s services.Stakeholder testing on the revised service specification took place from 8 June 2024 to 25 June 2024. 14 responses were received, six of which were on behalf of organisations and eight from individuals. Public consultation was carried out from 13 September to 12 October 2024. A total of 923 individuals responded to the public consultation, from across all regions and devolved nations of the United Kingdom.

If he will take make an assessment of the potential impact of NHS England's decision to reduce the number of contracted hyperbaric oxygen therapy centres on emergency care.

The Department is content with the assessments NHS England conducted regarding this procurement. The Equality and Health Inequalities Impact Assessment for this procurement is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2018/11/2.1-Hyperbaric-oxygen-therapy-equality-and-health-inequalities-impact-assessment.pdfNHS England is committed to ensuring equitably accessible, high-quality services for anyone who requires hyperbaric oxygen therapy (HBOT). This will be achieved through the commissioning of 6 geographically dispersed services across England. Three preferred providers have been identified to date, and a further procurement exercise will take place to identify the three remaining centres.The contract for HBOT services (“recompression”) was reviewed in 2024, as existing contract terms expired. This included an update of the service specification using the published full methods process and public consultation on the proposal to reduce the number of commissioned providers in England from eight to six centres. The updates to the specification seek to ensure timely access to treatment for the most acutely unwell patients with the specification requiring: the delivery of care that is integrated with other services including the emergency department, critical care, and other healthcare professionals as required; and facilities should be capable of receiving patients in any diagnostic category who may require advanced life support either immediately or during HBOT.The geographical scope of the six services will ensure that there are no more than four hours travelling time by road from coastal locations, furthest borders or between neighbouring commissioned HBOT centres; this is in line with good practice guidelines.

What (a) appeal and (b) review mechanism is available to hyperbaric oxygen therapy providers who wish to challenge the outcome of the recent NHS England commissioning process.

Information is available at the following link:https://www.england.nhs.uk/long-read/the-provider-selection-regime-statutory-guidance/#reviewing-decisions-during-the-standstill-periodThis describes the process for making a representation to seek a review of the decision made.

Whether NHS England carried out an impact assessment before deciding against commissioning hyperbaric oxygen therapy services in the (a) North East, (b) North West, (c) Midlands and (d) central London.

NHS England is committed to ensuring equitably accessible, high-quality services, for anyone who requires hyperbaric oxygen therapy (HBOT). This will be achieved through the commissioning of six geographically dispersed services across England. Three preferred providers have been identified to date, and a further procurement exercise will take place to identify the three remaining centres.The contract for HBOT services, also known as recompression, was reviewed in 2024, as existing contract terms expired. This included an update of the service specification using the published full methods process, and a public consultation on the proposal to reduce the number of commissioned providers in England from eight to six centres. Further information on the service specification, the published full methods process, and the consultation is available, respectively, at the following three links:https://www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdfhttps://www.england.nhs.uk/publication/methods-national-service-specifications/https://www.england.nhs.uk/long-read/reviewing-hyperbaric-oxygen-services-consultation-guide/#:~:text=Background-,Background,Manual%20of%20Prescribed%20Specialised%20ServicesThe updates to the specification seek to ensure timely access to treatment for the most acutely unwell patients with the specification requiring:the delivery of care that is integrated with other services, including the emergency department, critical care, and other healthcare professionals as required; andfacilities should be capable of receiving patients in any diagnostic category who may require advanced life support either immediately or during HBOT.The geographical scope of the six services will ensure that there are no more than four hours travelling time by road from coastal locations, from the furthest borders, or between neighbouring commissioned HBOT centres, which is in line with good practice guidelines. The published Equality and Health Inequalities Impact Assessment sets out an evaluation, including access to services and where appropriate action was taken to ensure fair access to any patient who requires this service. Further information on the Equality and Health Inequalities Impact Assessment is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2018/11/2.1-Hyperbaric-oxygen-therapy-equality-and-health-inequalities-impact-assessment.pdf

What steps NHS England is taking to ensure emergency access to hyperbaric oxygen therapy for patients in the (a) North East and (b) North West of England from 1 October 2025.

NHS England is committed to ensuring equitably accessible, high-quality services, for anyone who requires hyperbaric oxygen therapy (HBOT). This will be achieved through the commissioning of six geographically dispersed services across England. Three preferred providers have been identified to date, and a further procurement exercise will take place to identify the three remaining centres. NHS England is unable to provide details of timescales for the provider selection process for outstanding lots at this stage.The contract for HBOT services, also known as recompression, was reviewed in 2024, as existing contract terms expired. This included an update of the service specification using the published full methods process, and a public consultation on the proposal to reduce the number of commissioned providers in England from eight to six centres. Further information on the service specification, the published full methods process, and the consultation is available, respectively, at the following three links:https://www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdfhttps://www.england.nhs.uk/publication/methods-national-service-specifications/https://www.england.nhs.uk/long-read/reviewing-hyperbaric-oxygen-services-consultation-guide/#:~:text=Background-,Background,Manual%20of%20Prescribed%20Specialised%20ServicesThe updates to the specification seek to ensure timely access to treatment for the most acutely unwell patients with the specification requiring:the delivery of care that is integrated with other services, including the emergency department, critical care, and other healthcare professionals as required; andfacilities should be capable of receiving patients in any diagnostic category who may require advanced life support either immediately or during HBOT.The geographical scope of the six services will ensure that there are no more than four hours travelling time by road from coastal locations, from the furthest borders, or between neighbouring commissioned HBOT centres, which is in line with good practice guidelines. The published Equality and Health Inequalities Impact Assessment sets out an evaluation, including access to services and where appropriate action was taken to ensure fair access to any patient who requires this service. Further information on the Equality and Health Inequalities Impact Assessment is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2018/11/2.1-Hyperbaric-oxygen-therapy-equality-and-health-inequalities-impact-assessment.pdf

Whether NHS England conducted site visits to all hyperbaric oxygen therapy providers who submitted bids under the recent commissioning process.

Site visits were not conducted as part of the formal procurement and subsequent evaluation or scoring processes. All bids were evaluated solely on the written responses provided within the bid submissions, in accordance with the published criteria.Informal site visits, or an informal virtual meeting in the case of one provider, were held with the eight existing providers during 2024. These were solely to support the Commissioner’s understanding of service delivery models. Any information gathered during these visits was external to the provider selection process and was not considered in the scoring of the submissions from bidders.