Written questions by Vickers.

What steps are being taken to improve early identification of cognitive, behavioural, and emotional needs arising from acquired brain injury in children, particularly within school settings.

Children who have had a brain injury can be affected in different ways. Some brain injuries will result in a special educational need (SEN) or a medical need, whilst others may affect a child in other ways. In whatever way a brain injury manifests, it is essential that the pupil’s individual needs are identified and supported appropriately. Schools must make arrangements to support their pupils with medical conditions and must make reasonable adjustments to their practices, procedures and policies and not discriminate against their disabled pupils. The governing body should ensure that sufficient staff have received suitable training and are competent before they take on responsibility to support children with medical conditions. They should also ensure that any members of school staff who provide support to pupils with medical conditions, or those with SEN, are able to access information and other teaching support materials as needed. Mainstream schools must use their best endeavours to meet the special educational needs of their pupils, which includes those with acquired brain injury. Where needs are more complex the school may request the local authority to conduct an education, health and care needs assessment.

What evaluation has been undertaken of access to specialist educational provision for children with acquired brain injuries; and whether additional support is planned for emerging specialist schools such as those in Stockton-on-Tees.

Children who have had a brain injury can be affected in different ways. Some brain injuries will result in a special educational need (SEN) or a medical need, whilst others may affect a child in other ways. In whatever way a brain injury manifests, it is essential that the pupil’s individual needs are identified and supported appropriately. Schools must make arrangements to support their pupils with medical conditions and must make reasonable adjustments to their practices, procedures and policies and not discriminate against their disabled pupils. The governing body should ensure that sufficient staff have received suitable training and are competent before they take on responsibility to support children with medical conditions. They should also ensure that any members of school staff who provide support to pupils with medical conditions, or those with SEN, are able to access information and other teaching support materials as needed. Mainstream schools must use their best endeavours to meet the special educational needs of their pupils, which includes those with acquired brain injury. Where needs are more complex the school may request the local authority to conduct an education, health and care needs assessment.

What steps are being taken to ensure that data on paediatric traumatic brain injury diagnoses is collected consistently across the NHS to support the development of the Acquired Brain Injury Action Plan.

The Department recognises that consistent and comprehensive data on traumatic brain injury (TBI) is essential to improving care and informing policy. The forthcoming Acquired Brain Injury (ABI) Action Plan will include measures to strengthen data collection and access across the National Health Service and wider services. This will ensure that information on diagnosis and treatment of TBI is gathered systematically and shared effectively to support integrated care, commissioning decisions and evidence-based planning, and to underpin the action plan’s goal of improving prevention, diagnosis, rehabilitation, and long-term support for children and young people, as well as adults, affected by TBI.

What assessment has been made of the adequacy of community-based neurorehabilitation provision for children and young people following an acquired brain injury, particularly in regions with high incidence rates such as Teesside.

The Department recognises the importance of timely, high-quality rehabilitation for children and young people with an acquired brain injury (ABI). NHS England’s paediatric neurorehabilitation service specification supports community neurorehabilitation by ensuring that children and young people receive coordinated, specialist care beyond the hospital setting. It requires integrated care boards (ICBs), including the NHS North East and North Cumbria ICB, to work with tertiary centres and local providers to deliver structured rehabilitation programmes in the community, supported by multidisciplinary teams.The Department expects all National Health Services to follow the guideline for the assessment and early management of head injury in babies, children, young people, and adults, reference code NG232, published by the National Institute for Health and Care Excellence (NICE). The guideline sets out clear standards for discharge advice, risk assessment, and timely referral for further evaluation where symptoms persist or escalate. NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements. NICE provides ICBs with implementation tools, audit templates, training resources, and commissioning guidance to help embed the guideline into local pathways and ensure consistent, evidence-based practice.The Government is committed to increasing specialist neurorehabilitation capacity in the North East of England as part of wider efforts to improve access and reduce regional variation. Our forthcoming ABI Action Plan will set out practical steps to strengthen commissioning and expand multidisciplinary rehabilitation services. This aligns with commitments in the 10-Year Health Plan to enhance community-based rehabilitation, invest in specialist teams, and ensure timely, high-quality care for people with ABI across England, including the North East.

What recent work has been undertaken with voluntary sector organisations supporting families affected by acquired brain injury; and how their expertise is being incorporated into the Acquired Brain Injury Action Plan.

The Department is working closely with NHS England, other Government departments, and stakeholders to finalise the Acquired Brain Injury (ABI) Action Plan, which will set out clear priorities for improving prevention, diagnosis, rehabilitation, and long-term support. Work on the plan is well advanced, and we expect to publish the plan in the first half of 2026.The Department has worked closely with leading ABI charities through stakeholder forums, the ABI All-Party Parliamentary Group, and a national call for evidence. These organisations have provided expert insight on rehabilitation pathways, community support, and service gaps. Their contributions are directly shaping the plan by informing priorities and practical actions to improve outcomes for individuals and families affected by ABI.

What progress has been made on developing the cross-departmental Acquired Brain Injury Action Plan; and what mechanisms are in place to ensure the plan addresses regional inequalities in neurorehabilitation services.

The Department is working closely with NHS England, other Government departments, and stakeholders to finalise the Acquired Brain Injury (ABI) Action Plan, which will set out clear priorities for improving prevention, diagnosis, rehabilitation, and long-term support. Work on the plan is well advanced, and we expect to publish the plan in the first half of 2026.The Department has worked closely with leading ABI charities through stakeholder forums, the ABI All-Party Parliamentary Group, and a national call for evidence. These organisations have provided expert insight on rehabilitation pathways, community support, and service gaps. Their contributions are directly shaping the plan by informing priorities and practical actions to improve outcomes for individuals and families affected by ABI.

What plans there are to expand specialist neurorehabilitation capacity in the North East.

The Department recognises the importance of timely, high-quality rehabilitation for children and young people with an acquired brain injury (ABI). NHS England’s paediatric neurorehabilitation service specification supports community neurorehabilitation by ensuring that children and young people receive coordinated, specialist care beyond the hospital setting. It requires integrated care boards (ICBs), including the NHS North East and North Cumbria ICB, to work with tertiary centres and local providers to deliver structured rehabilitation programmes in the community, supported by multidisciplinary teams.The Department expects all National Health Services to follow the guideline for the assessment and early management of head injury in babies, children, young people, and adults, reference code NG232, published by the National Institute for Health and Care Excellence (NICE). The guideline sets out clear standards for discharge advice, risk assessment, and timely referral for further evaluation where symptoms persist or escalate. NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements. NICE provides ICBs with implementation tools, audit templates, training resources, and commissioning guidance to help embed the guideline into local pathways and ensure consistent, evidence-based practice.The Government is committed to increasing specialist neurorehabilitation capacity in the North East of England as part of wider efforts to improve access and reduce regional variation. Our forthcoming ABI Action Plan will set out practical steps to strengthen commissioning and expand multidisciplinary rehabilitation services. This aligns with commitments in the 10-Year Health Plan to enhance community-based rehabilitation, invest in specialist teams, and ensure timely, high-quality care for people with ABI across England, including the North East.

What assessment has been made of the economic impact of acquired brain injury on local authorities and health systems; and how that information is informing future funding models for neurorehabilitation.

The Department recognises the significant economic impact of acquired brain injury (ABI) on both the National Health Service and local authorities due to the costs of acute care, long-term rehabilitation, social care, and support for education and employment.This is informing the development of future funding models for locally commissioned neurorehabilitation by emphasising the value of early, intensive rehabilitation in reducing long-term costs and improving outcomes. The ABI Action Plan will set out proposals to strengthen commissioning frameworks, promote integrated funding approaches between health and social care, and ensure resources are targeted where they deliver the greatest benefit.

What recent assessment has been made of (a) the effectiveness of follow-up pathways for children discharged from A&E after a head injury and (b) whether current practice aligns with national clinical guidelines.

The Department recognises the importance of timely, high-quality rehabilitation for children and young people with an acquired brain injury (ABI). NHS England’s paediatric neurorehabilitation service specification supports community neurorehabilitation by ensuring that children and young people receive coordinated, specialist care beyond the hospital setting. It requires integrated care boards (ICBs), including the NHS North East and North Cumbria ICB, to work with tertiary centres and local providers to deliver structured rehabilitation programmes in the community, supported by multidisciplinary teams.The Department expects all National Health Services to follow the guideline for the assessment and early management of head injury in babies, children, young people, and adults, reference code NG232, published by the National Institute for Health and Care Excellence (NICE). The guideline sets out clear standards for discharge advice, risk assessment, and timely referral for further evaluation where symptoms persist or escalate. NHS England ensures that ICBs follow NICE guidance through a combination of statutory oversight frameworks, annual performance assessments, and local clinical governance requirements. NICE provides ICBs with implementation tools, audit templates, training resources, and commissioning guidance to help embed the guideline into local pathways and ensure consistent, evidence-based practice.The Government is committed to increasing specialist neurorehabilitation capacity in the North East of England as part of wider efforts to improve access and reduce regional variation. Our forthcoming ABI Action Plan will set out practical steps to strengthen commissioning and expand multidisciplinary rehabilitation services. This aligns with commitments in the 10-Year Health Plan to enhance community-based rehabilitation, invest in specialist teams, and ensure timely, high-quality care for people with ABI across England, including the North East.

How many geriatricians have specialist training in Parkinson’s disease; and what plans he has to increase their numbers.

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

How many neurologists have specialist training in Parkinson’s disease; and if he will estimate the espected number of neurologists with specialist training in Parkinson’s over the next five years.

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

What assessment he has made of the capacity of the specialist Parkinson’s workforce to meet increasing demand for care and diagnosis.

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

How many specialist Parkinson’s nurses are employed in the NHS; and how their distribution is monitored nationally.

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

What steps he is taking to ensure that Integrated Care Boards do not cut essential services for people living with Parkinson’s.

The Department does not hold data on the number of neurologists or geriatricians with specialist training in Parkinson’s disease, nor does NHS England publish workforce projections at this level of granularity. Neurologists typically manage a wide range of conditions, including Parkinson’s, and geriatricians are trained to manage a broad range of complex health needs in older people. Workforce data is collected for the specialty as a whole rather than by sub-specialty.As of August 2025, there were 2,010 full-time equivalent (FTE) doctors working in the specialty of neurology and 6,284 in geriatric medicine in National Health Service trusts and other organisations in England. This includes 1,025 FTE consultant neurologists and 1,687 FTE consultant geriatricians.The Department does not hold specific data on the number of specialist Parkinson’s nurses currently working in the NHS in England. These roles are commissioned and managed locally by NHS trusts and integrated care boards (ICBs) as part of neurology and movement disorder services.NHS England uses workforce modelling to establish potential future scenarios for both the supply of, and demand for, NHS workers across all specialties. In doing so, they analyse a range of factors, including population health trends, service utilisation patterns, and projected retirement and training rates. This modelling helps determine the number of training places required and informs long-term workforce planning, ensuring that specialties such as neurology and geriatric medicine have sufficient capacity to meet anticipated needs.The Government will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. It will ensure that the NHS has the right people in the right places, with the right skills to care for patients, including those with Parkinson’s disease, when they need it. We are working through how the plan will articulate the changes for different professional groups.The Department recognises the importance of maintaining high-quality services for people living with Parkinson’s disease. NHS England sets clear expectations of ICBs through national service specifications as well as guidance provided through initiatives like the Getting it Right First Time and RightCare Programmes to ensure equitable access to care for people with neurological conditions, including Parkinson’s. NHS England monitors ICB performance through planning guidance and assurance processes to ensure compliance with national standards and to prevent inappropriate service reductions.

Food and Rural Affairs, what estimate her Department has made of the number of waste-processing facilities currently operating with expired permits.

Environmental Permitting Regulations require operators of industrial/waste facilities to get permits from regulators to control pollution to air, land, and water, ensuring compliance with set conditions, and protecting public health through legal frameworks. Waste management site permits do not expire; they have to be surrendered by the permit holder. Therefore, there are no sites operating with expired permits.

Food and Rural Affairs, what steps her Department is taking to support the development of sustainable aquaculture.

The Government is committed to supporting sustainable, industry‑led growth of the aquaculture sector through a range of measures. These include publishing new guidance on seaweed aquaculture regulation this year and offering clarity for businesses and regulators. The Centre for Environment, Fisheries and Aquaculture Science, working with Seafish and industry partners, is centralising aquaculture data for England and Wales to improve transparency and evidence‑based decision making. The Environment Agency continues to regulate wastewater discharges to safeguard waters used for commercial shellfish production. While many aquaculture issues are devolved, the Government will champion sustainably produced aquaculture products from across the UK internationally. A thriving sector requires a strong trading framework, and the government is committed to building relationships with key trading partners.

Food and Rural Affairs, what steps her Department is taking to improve water quality monitoring in designated bathing areas.

The Environment Agency (EA) monitors designated bathing waters above the minimum frequency required in the Bathing Water Regulations during the bathing water season. Most sites are sampled weekly, following World Health Organisation recommendations and to reduce misclassification risk. On 28 October 2025, the Department laid before Parliament a Statutory Instrument introducing reforms and technical amendments to the Bathing Water Regulations, which predominantly came into force 21 November 2025. The reforms include the discretion to determine a different bathing season for a site, enabling tailored seasons and monitoring periods that reflect when people use the bathing waters, strengthening public health messaging. The technical amendments align legislation with modern sampling practices, allowing the EA to improve efficiency and delivery for the public. The EA also has an active Research and Development programme exploring innovative contamination detection at bathing waters and participate with other UK and international agencies on the development of analytical techniques.

Food and Rural Affairs, what estimate the Department has made of the number of communities that remain without modern flood-defence infrastructure.

The Environment Agency (EA)’s National Flood risk assessment data and national coastal erosion risk map provides the best evidence to inform our long-term risk assessment and the development of flood mitigation strategies to protect communities from flooding. The EA maintains over 90,000 assets, which reduce the risk of flooding to 2.6 million properties in England. The EA is delivering the Government’s flood and coastal risk management (FCRM) Investment Programme of flood and coastal defences, investing £2.65 billion over 2024/5 and 2025/6 with a target of 52,000 properties better protected. A new 3-year £4.2 billion FCRM Investment Programme will start in April 2026, progressing projects already in construction and new projects that are either currently in development or still to be developed.

Food and Rural Affairs, what steps her Department is taking to improve resilience to flooding in high-risk communities.

This Government is investing at least £10.5 billion until 2036 – the largest flood programme in history – a record investment that’s projected to better protect nearly 900,000 properties. We are already making a difference. We delivered 151 schemes in our first year in Government and £108 million was reprioritised into urgent flood and coastal defence maintenance to halt the decline of flood asset condition following years of under-investment. Following consultation in October, the Government announced major changes to its flood and coastal erosion funding policy. The new funding policy will optimise funding between building new flood projects and maintaining existing defences and will ensure that deprived communities continue to receive vital investment. Flood Re is a UK-wide flood re-insurance scheme with the purpose to provide reinsurance in such a way as to promote affordability and availability of insurance for UK households at high flood risk. It also aims to manage, over the period of operation of the scheme, the transition to risk-reflective pricing of flood insurance for household premises.

What recent assessment his Department has made of potential changes in the retention of (a) engineering and (b) technical specialists.

We remain committed to strengthening recruitment and retention across the Armed Forces through a range of targeted initiatives and measures. We continually monitor retention and review the overall offer, and recent data shows encouraging progress. For the first time since early 2021, intake now exceeds outflow. In the 12 months to 1 October 2025, the number of people joining the Armed Forces increased by 13% compared to the previous year, while departures fell by 8%. Applications also continue to rise. Recruiting for certain specialist or technical skills — such as cyber, digital, healthcare, medical, and engineering — remains challenging due to strong competition in the wider labour market. To address this, we are implementing actions to improve retention, including more flexible terms of service, a modernised allowance system, bespoke pay spines, skills payments, Targeted Financial Retention Incentives (FRIs) and a pilot ‘total reward’ approach for engineers. Recent changes include FRIs for engineers and targeted skills payments for cyber and engineering roles. Early feedback from our pay supplement trial for critical engineering skills indicates a 53% increase in intention to remain – an encouraging sign, though we recognise more work is needed. Further, the Perceived Value of the Offer survey piloted with engineers in 2024 was expanded this year to all Regular personnel. This evidence will inform future reward policies and interventions, ensuring they reflect what personnel value most, thus strengthening retention across the Services, particularly in critical engineering and technical roles.