Written questions by Vickers.

What steps he is taking to ensure equitable access to specialist blood cancer treatment for patients in rural areas.

Reducing the number of lives lost to cancer is a key aim of the National Cancer Plan, which will be published later this year. The plan will include further details on how we will improve outcomes for cancer patients, including blood cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, ultimately driving up this country’s cancer survival rates. The National Cancer Plan will have patients at its heart, and the Department has been working closely with patient organisations and other cancer partners as part of our engagement to inform the development of the plan. This includes patient and family engagement events with partners such as Macmillan and Maggies, and engagement with blood cancer charities and the NHS Patient and Public Voice Forum.Early diagnosis is a key focus of the National Cancer Plan. It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers, as early and quickly as possible, and to treat it faster, to improve outcomes. To tackle the late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways. We will get the NHS diagnosing blood cancers earlier and treating them faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners. Furthermore, the 10-Year Health Plan’s commitment to putting digital health at the heart of the future health service, and integrating that with a single patient record and neighbourhood health services, will mean that cancer patients will get the joined-up care they deserve.The National Cancer Plan will also seek to ensure that high-quality care is available to patients across the country, including patients in rural areas. This will build on the current national cancer audits, which are seeking to promote best practice and aim to reduce inequalities in the access to, or the quality of, treatment. Further details on the steps that will be taken to achieve this will be set out in the plan. Service providers are responsible for making clinical decisions about prioritisation in response to capacity constraints, taking into consideration national guidance, and access and waiting time standards, so that patients are prioritised.Haematopoietic stem cell transplantation (HSCT) is a potential treatment for a range of malignant and non-malignant indications, including myeloma. HSCT is a specialised service and is the commissioning responsibility of integrated care boards.NHS England is the accountable commissioner for HSCT and has published a national service specification that all commissioned HSCT services need to meet. The list of commissioned indications is covered by the NHS England Clinical Commissioning Policy available at the following link:https://www.england.nhs.uk/wp-content/uploads/2022/10/Haematopoietic-Stem-Cell-Transplantation-HSCT-All-Ages.pdfThere are currently no plans to expand the number of specialised centres that deliver HSCT treatments.Blood cancer in and of itself is not a disease that is specialised, however, some of the treatments used to manage blood cancers are within specialised services, such as HSCT. NHS England publishes national service specifications for specialised services and monitors the quality-of-service provision and patient outcomes via the NHS England quality dashboards, and in the case of HSCT, by also reviewing the service-level reports published by the British Society of Blood and Marrow Transplantation and Cellular Therapy. The findings of the reviews of these reports are discussed with NHS England regional teams who determine any appropriate action that needs to be taken with the providers within their region.

What assessment he has made of the effectiveness of data sharing between hospitals and primary care in improving early diagnosis of blood cancers.

Reducing the number of lives lost to cancer is a key aim of the National Cancer Plan, which will be published later this year. The plan will include further details on how we will improve outcomes for cancer patients, including blood cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, ultimately driving up this country’s cancer survival rates. The National Cancer Plan will have patients at its heart, and the Department has been working closely with patient organisations and other cancer partners as part of our engagement to inform the development of the plan. This includes patient and family engagement events with partners such as Macmillan and Maggies, and engagement with blood cancer charities and the NHS Patient and Public Voice Forum.Early diagnosis is a key focus of the National Cancer Plan. It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers, as early and quickly as possible, and to treat it faster, to improve outcomes. To tackle the late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways. We will get the NHS diagnosing blood cancers earlier and treating them faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners. Furthermore, the 10-Year Health Plan’s commitment to putting digital health at the heart of the future health service, and integrating that with a single patient record and neighbourhood health services, will mean that cancer patients will get the joined-up care they deserve.The National Cancer Plan will also seek to ensure that high-quality care is available to patients across the country, including patients in rural areas. This will build on the current national cancer audits, which are seeking to promote best practice and aim to reduce inequalities in the access to, or the quality of, treatment. Further details on the steps that will be taken to achieve this will be set out in the plan. Service providers are responsible for making clinical decisions about prioritisation in response to capacity constraints, taking into consideration national guidance, and access and waiting time standards, so that patients are prioritised.Haematopoietic stem cell transplantation (HSCT) is a potential treatment for a range of malignant and non-malignant indications, including myeloma. HSCT is a specialised service and is the commissioning responsibility of integrated care boards.NHS England is the accountable commissioner for HSCT and has published a national service specification that all commissioned HSCT services need to meet. The list of commissioned indications is covered by the NHS England Clinical Commissioning Policy available at the following link:https://www.england.nhs.uk/wp-content/uploads/2022/10/Haematopoietic-Stem-Cell-Transplantation-HSCT-All-Ages.pdfThere are currently no plans to expand the number of specialised centres that deliver HSCT treatments.Blood cancer in and of itself is not a disease that is specialised, however, some of the treatments used to manage blood cancers are within specialised services, such as HSCT. NHS England publishes national service specifications for specialised services and monitors the quality-of-service provision and patient outcomes via the NHS England quality dashboards, and in the case of HSCT, by also reviewing the service-level reports published by the British Society of Blood and Marrow Transplantation and Cellular Therapy. The findings of the reviews of these reports are discussed with NHS England regional teams who determine any appropriate action that needs to be taken with the providers within their region.

What assessment he has made of the potential implications for his policies of international best practice in the provision of osteoporosis diagnosis services; and whether he is applying lessons learned from those practices to NHS policy.

In the last three years, two new drugs have been recommended by the National Institute for Health and Care Excellence (NICE) for the treatment of osteoporosis in post-menopausal women, namely abaloparatide and romosozumab. These medications help to strengthen the bones and prevent bone loss, thereby reducing the risk of fractures. The National Health Service is legally required to make funding available for treatments recommended by NICE.We have invested in 13 new bone density, or DEXA, scanners, which are expected to provide up to 29,000 extra scans per year to ensure people with bone conditions get diagnosed earlier.The National Fracture Liaison Service database is a clinically led national audit of secondary fracture prevention in England and Wales and is commissioned by the Healthcare Quality Improvement Partnership and delivered by the Royal College of Physicians. It collects and publishes data on individual Fracture Liaison Services and uses internationally recognised standards as the key performance indicators that these services are measured against. The data is publicly available.

What assessment his Department has made of the potential impact of the absence of universal access to fracture liason services on the number of preventable deaths from hip fractures each year.

The Department has not made an assessment of the impact of Fracture Liaison Services on preventable deaths from hip fractures.

What steps the NHS is taking to improve access to clinical trials for people with rare blood cancers.

The Department is committed to ensuring that all patients in the National Health Service, including those with rare blood cancers, have access to cutting-edge clinical trials and innovative, lifesaving treatments.The Department-funded National Institute for Health and Care Research (NIHR) funds research and research infrastructure, which supports NHS patients, the public, and NHS organisations across England, to participate in high-quality research, including clinical trials into rare blood cancers. NIHR infrastructure schemes aim to build research capacity and capability across all geographies, settings, and disease areas within the NHS.The forthcoming National Cancer Plan will include further details on how we will improve access to clinical trials in the NHS for cancer patients across the country, including patients with rare cancers.The Government also supports the Rare Cancers Bill and its ambitions to incentivise clinical trials and access to innovative treatments for rare cancers.The NIHR provides an online service called 'Be Part of Research', which promotes participation in health and social care research by allowing users to search for relevant studies and register their interest. This makes it easier for people to find and take part in health and care research that is relevant to them, including research into blood cancer.

Whether he is taking steps to make workforce data transparent at (a) trust and (b) ICB level.

There are a range of data sources published by NHS England relating to staff employed by National Health Service trusts and integrated care boards (ICB) in England, including monthly data on NHS workforce statistics, including information on the current staff in post as well as turnover. This information is provided at a trust level and ICB level as well as at a national level, and is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics There is also monthly data on sickness absence rates for staff working in the NHS. As well as containing data on national sickness absence rates across staff groups, this data is also available at an ICB and trust level at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-sickness-absence-rates There is also quarterly data on vacancy rates in NHS trusts at a regional level, available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey The above is also, on an ad hoc basis, published at trust level, such as in the supplementary release available at the following link:https://digital.nhs.uk/supplementary-information/2024/total-vacancy-rates-by-org-since-201718 Additionally, the results of the annual NHS Staff Survey are also available at trust level at the following link:https://www.nhsstaffsurveys.com/results/national-results/ The Department and NHS England continue to review and develop available data sources on the NHS workforce at a local level.

What assessment his Department has made of the potential impact of the use of (a) agency and (b) locum staff on reducing waiting lists.

The Department has not made an assessment and has no plans to make an assessment on the impact of regional variations in staff vacancy rates, the time taken to recruit into nursing roles, or the use of agency and bank staff, on elective waiting list lengths.NHS England published its planning guidance for 2025/26 in January 2025. This guidance sets out clear priorities for the National Health Service including delivery of the interim electives ambition of meeting nationally 65% of patients being seen within 18 weeks, along with a minimum 5% improvement, that was set out in the Elective Reform Plan.It is for trusts and integrated care boards to manage staffing of all professions, including through use of agency and bank staff, to deliver on these priorities within their agreed financial allocations.

Whether his Department is monitoring the number of administrative staff working in NHS back office functions; and what assessment he has made of the potential impact of reductions in those staff on (a) front-line staffing and (b) waiting lists.

The Department monitors monthly Hospital and Community Health Services workforce statistics for England which are published by NHS England. These cover staff employed by hospital trusts and integrated care boards. The published statistics include data for the National Health Service infrastructure workforce, which includes NHS managers, staff working in central functions, such as human resources and finance, and staff working in property and estates roles. These are available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics No specific central assessment of the impact of changes in the levels of NHS infrastructure roles has been undertaken by the Department but local bodies were tasked through the 2025-26 NHS Priorities and Operational Planning Guidance to review and monitor expenditure on non-frontline staff in order to prioritise frontline care. This guidance also reiterates the ambition of meeting nationally the target of 65% of patients being seen within 18 weeks, along with a minimum 5% improvement, that was set out in the Elective Reform Plan.

If he will make an assessment of the potential impact of the time taken to recruit into nursing roles on elective care backlogs.

The Department has not made an assessment and has no plans to make an assessment on the impact of regional variations in staff vacancy rates, the time taken to recruit into nursing roles, or the use of agency and bank staff, on elective waiting list lengths.NHS England published its planning guidance for 2025/26 in January 2025. This guidance sets out clear priorities for the National Health Service including delivery of the interim electives ambition of meeting nationally 65% of patients being seen within 18 weeks, along with a minimum 5% improvement, that was set out in the Elective Reform Plan.It is for trusts and integrated care boards to manage staffing of all professions, including through use of agency and bank staff, to deliver on these priorities within their agreed financial allocations.

If he will make an assessment of the potential impact of regional variations in staff vacancy rates on waiting list lengths in NHS trusts.

The Department has not made an assessment and has no plans to make an assessment on the impact of regional variations in staff vacancy rates, the time taken to recruit into nursing roles, or the use of agency and bank staff, on elective waiting list lengths.NHS England published its planning guidance for 2025/26 in January 2025. This guidance sets out clear priorities for the National Health Service including delivery of the interim electives ambition of meeting nationally 65% of patients being seen within 18 weeks, along with a minimum 5% improvement, that was set out in the Elective Reform Plan.It is for trusts and integrated care boards to manage staffing of all professions, including through use of agency and bank staff, to deliver on these priorities within their agreed financial allocations.

Whether his Department plans to take steps to review court procedures to ensure deaf jurors are not excluded from panels on the grounds of the cost of the provision of British Sign Language interpretation.

The Government is committed to opening up jury service to as many eligible people as possible and ensuring disability is never a barrier. No juror is expected to meet the cost of interpreting. HM Courts & Tribunals Service (HMCTS) arranges and funds British Sign Language interpreting for jurors throughout their service, including during deliberations, via national language service contracts. Jurors may also claim loss of earnings and other allowances under existing regulations, so cost should not prevent eligible deaf people from serving. HMCTS keeps operational procedures under review with the judiciary to ensure provision is timely and effective and that eligible jurors are not excluded from panels on cost grounds.

Whether his Department has consulted with organisations representing deaf people on the barriers faced by deaf people when undertaking jury service.

The Ministry of Justice engaged with organisations representing deaf people, including the British Deaf Association, when developing and implementing new measures in the Police, Crime, Sentencing and Courts Act, to support jurors who require the support of BSL interpreters in the deliberation room. We continue to collect feedback from jurors and courts to improve and refine our processes and share best practice.

What assessment his Department has made of the potential impact of interpreter absence on the ability of deaf jurors to fully participate in court proceedings.

The Government is committed to ensuring that all jurors are able to participate effectively in the Criminal Justice System. Since new legislative provisions came into force in 2022, deaf jurors may be granted the assistance of British Sign Language (BSL) interpreters in the jury deliberation room. If an interpreter is unavailable at any point, it is for the trial judge to decide whether to proceed or to adjourn until appropriate support is in place. Courts source interpreters through the Ministry of Justice’s contracted suppliers, with contingency arrangements (including booking pairs of BSL interpreters for deliberations) to manage fatigue and ensure quality. HMCTS guidance makes clear that reasonable adjustments must be put in place to enable jurors with disabilities to participate, and that interpreter support should be arranged promptly where required. Where an interpreter is temporarily unavailable, jury officers and the judge will consider appropriate interim steps, such as written communication, assistive listening technology, or a brief adjournment, so that the juror is not disadvantaged. Judicial guidance in the Equal Treatment Bench Book underlines that arrangements are judicially led in line with legislation.

How many complaints has HM Courts and Tribunals Service received from deaf jurors regarding interpreter provision in the last five years.

The Police, Crime, Sentencing and Courts Act 2022 placed the right to British Sign Language (BSL) interpreting in the jury deliberation room on a statutory footing (now section 9C of the Juries Act 1974). The Ministry of Justice is committed to ensuring the justice system is supported by a range of high-quality language services that meet the needs of all those that require them. Visual and tactile provisions, including sign language interpreters, are met and monitored through the Ministry of Justice's language services contract with Clarion Interpreting Ltd.Whilst HM Courts and Tribunals Service (HMCTS) does not record protected characteristics of jurors in respect of complaints, an interrogation of data held suggests that there have been two recorded complaints regarding interpreter provision for jury service support in the last five years. When concerns are raised, HMCTS addresses them at a local level and, where appropriate, escalates issues through established contract management processes and ongoing improvements in data quality and governance.The quality of interpreting provided to the Department, including the management of its register of interpreters, is assured by an independent provider, The Language Shop (TLS). TLS undertakes a programme of assessments for interpreters, as well as an annual audit of supplier processes for onboarding new interpreters. These safeguards ensure the legal right is delivered in practice while maintaining the integrity of the jury room.

What estimate his Department has made of the number of deaf people who have completed jury service since the coming into force of the legal right to British Sign Language interpreters in jury deliberation rooms in the Police, Crime, Sentencing and Courts Act 2022.

Since the Police, Crime, Sentencing and Courts Act came into force in 2022, there have been 84 bookings made for BSL interpreters to assist a deaf juror in deliberations.HMCTS collects a range of information to support the administration of jury service and to fulfil its Public Sector Equality Duty, and this is regularly reviewed to ensure it is robust and proportionate. Information on adjustments made for individual jurors is not held centrally.

Whether his Department has considered setting national minimum standards for British Sign Language interpreter provision across all courts.

The Ministry of Justice has set national minimum standards for British Sign Language (BSL) interpreter provision across courts through the Language Services Contract. All interpreters must be registered with a voluntary National Regulator for Language Service professionals, with the minimum qualification standard for court work being a Level 6 BSL qualification.

What recent assessment his Department has made of the adequacy of data collection on (a) deaf jurors and (b) jurors with other protected characteristics within jury service records.

Since the Police, Crime, Sentencing and Courts Act came into force in 2022, there have been 84 bookings made for BSL interpreters to assist a deaf juror in deliberations.HMCTS collects a range of information to support the administration of jury service and to fulfil its Public Sector Equality Duty, and this is regularly reviewed to ensure it is robust and proportionate. Information on adjustments made for individual jurors is not held centrally.

What steps his Deaprtment is taking to ensure that cost does not prevent deaf people from serving as jurors.

The Government is committed to opening up jury service to as many eligible people as possible and ensuring disability is never a barrier. No juror is expected to meet the cost of interpreting. HM Courts & Tribunals Service (HMCTS) arranges and funds British Sign Language interpreting for jurors throughout their service, including during deliberations, via national language service contracts. Jurors may also claim loss of earnings and other allowances under existing regulations, so cost should not prevent eligible deaf people from serving. HMCTS keeps operational procedures under review with the judiciary to ensure provision is timely and effective and that eligible jurors are not excluded from panels on cost grounds.

Whether his Department has made an assessment of the potential merits of fast-tracking accreditation for internationally-trained healthcare professionals to help increase local staffing levels.

Healthcare professional regulators are the independent bodies responsible for safeguarding patient and public safety by ensuring that only those meeting the necessary standards can be added to their registers and work in the United Kingdom, whether qualified in the UK or overseas.As healthcare regulators are independent of Government, it is for regulators to determine the required processes and thresholds for registration. Some regulators already provide supported pathways for different groups of overseas qualified professionals, for example, refugees.Current arrangements under provisions in the EU Exit Regulations, known as the ‘standstill’ provisions, ensure that UK regulators continue to automatically recognise relevant European Union, European Economic Area and Swiss healthcare qualifications as they did before the UK left the EU. This enables applicants holding these qualifications to achieve UK registration more quickly.While achieving UK registration as an international healthcare professional should be as efficient and fast as possible, it is important that it remains a robust safeguard for patient protection.In addition, the Government is committed to developing homegrown talent and giving opportunities to more people across the country to join our National Health Service. The 10 Year Workforce Plan will outline strategies for improving retention, productivity, training, and reducing attrition, enhancing conditions for all staff, while gradually reducing reliance on international recruitment, without diminishing the value of their contributions.

Whether his Department monitors compliance with the legal right to British Sign Language interpreters in jury deliberation rooms in the Police, Crime, Sentencing and Courts Act 2022.

The Police, Crime, Sentencing and Courts Act 2022 placed the right to British Sign Language (BSL) interpreting in the jury deliberation room on a statutory footing (now section 9C of the Juries Act 1974). The Ministry of Justice is committed to ensuring the justice system is supported by a range of high-quality language services that meet the needs of all those that require them. Visual and tactile provisions, including sign language interpreters, are met and monitored through the Ministry of Justice's language services contract with Clarion Interpreting Ltd.Whilst HM Courts and Tribunals Service (HMCTS) does not record protected characteristics of jurors in respect of complaints, an interrogation of data held suggests that there have been two recorded complaints regarding interpreter provision for jury service support in the last five years. When concerns are raised, HMCTS addresses them at a local level and, where appropriate, escalates issues through established contract management processes and ongoing improvements in data quality and governance.The quality of interpreting provided to the Department, including the management of its register of interpreters, is assured by an independent provider, The Language Shop (TLS). TLS undertakes a programme of assessments for interpreters, as well as an annual audit of supplier processes for onboarding new interpreters. These safeguards ensure the legal right is delivered in practice while maintaining the integrity of the jury room.