Written questions by Wilkinson.

What assessment his Department has made of the adequacy of social care support available to those diagnosed with Functional Neurological Disorder.

In October 2025, the National Institute for Health and Care Excellence published guidance on rehabilitation for chronic neurological disorders, including acquired brain injury, with the reference code NG252. This guidance includes functional neurological disorder (FND) within its scope.NHS England’s updated Specialised Neurology Service Specification, published in August 2025, includes specific reference to FND. It states that all specialised neurology centres must include access to treatment services for FND. Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care.There are a number of other national-level initiatives supporting service improvement and better care for patients with neurological conditions, including FND, such as the Getting It Right First Time Programme for Neurology and the recently completed Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care markets to meet the diverse needs of all local people. In doing so, they should use local population and market data to inform commissioning decisions and encourage a wide range of service provision to ensure that people have a choice of appropriate and high-quality care services in their local area, including for conditions such as FND.

What steps his Department is taking to raise awareness of Functional Neurological Disorder.

In October 2025, the National Institute for Health and Care Excellence published guidance on rehabilitation for chronic neurological disorders, including acquired brain injury, with the reference code NG252. This guidance includes functional neurological disorder (FND) within its scope.NHS England’s updated Specialised Neurology Service Specification, published in August 2025, includes specific reference to FND. It states that all specialised neurology centres must include access to treatment services for FND. Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care.There are a number of other national-level initiatives supporting service improvement and better care for patients with neurological conditions, including FND, such as the Getting It Right First Time Programme for Neurology and the recently completed Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care markets to meet the diverse needs of all local people. In doing so, they should use local population and market data to inform commissioning decisions and encourage a wide range of service provision to ensure that people have a choice of appropriate and high-quality care services in their local area, including for conditions such as FND.

What data his Department holds on the (i) number and (ii) adequacy of provision of paediatric post-mortem specialists in (a) Gloucestershire, (b) the South West and (c) England.

The Department does not hold information on the number of paediatric post mortem specialists either across England or in the South West or Gloucestershire regions.NHS England does publish monthly information on the number of staff employed in the National Health Service in England, including information on the grade and specialty of NHS doctors. This includes information on the number of doctors working in the specialty of pathology as well as the sub-specialty of paediatric and perinatal pathology. This is not though the same as those able to provide paediatric post mortems. The relevant information can be found in the file ‘NHS HCHS Workforce Statistics, Trusts and core organisations – data tables’ in each monthly publication, at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statisticsNHS England established a national programme in late 2022 to address paediatric and perinatal pathologist workforce challenges and has undertaken significant work in relation to workforce funding, training, and incentives. This has included making additional funding available to support training posts in areas where there have been interested candidates but no training post available and changes to the national training course and examination structure. The number of training posts has increased across several recruitment rounds and the perinatal and paediatric training pathway will be at a full complement of 16 training posts from February 2026.

What recent assessment has been made on the relationship between ADHD and Substance Use Disorders.

Studies have shown that people with attention deficit hyperactivity disorder (ADHD) are at increased risk of alcohol use disorder. One study found that impulsive decision making was causal, and that ADHD was present in up to 20% of people seeking treatment for alcohol use disorder. The recently published Clinical Guidelines for Alcohol Treatment set out several steps that treatment providers should take to assist those with ADHD to access alcohol treatment and tailor treatment interventions, including discussing and making reasonable adjustments based on each person's individual needs, offering flexibility, providing information in the most appropriate way, and collaborative personalised care plans.It is the responsibility of integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to ADHD assessment and support, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England established an ADHD Taskforce which brought together those with lived experience with experts from the National Health Service, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. The final report was published on 6 November 2025. The work of the independent ADHD Taskforce highlighted the need for coordinated action across health, education, and public services to reform ADHD services and support.My Rt Hon. Friend, the Secretary of State for Health and Social Care, announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism.The independent review will build directly on the evidence and recommendations of the ADHD Taskforce. The taskforce’s report provides a strong, evidence‑based foundation, and the review will consider its findings in full to ensure conclusions are aligned and complementary. In the meantime, we are working with NHS England to deliver some of the taskforce’s recommendations such as on data improvement, enhancing Mental Health Support Teams in Schools, improved commissioning, and better collaboration between mental health and primary care services.

Whether it is his policy that integrated care board boundaries should match mayoral combined authority boundaries.

It remains the Government’s ambition for integrated care boards (ICBs) to be coterminous with one or more strategic authorities wherever feasible, a commitment made in the English devolution white paper and reaffirmed in our 10-Year Health Plan.This summer as local government reform progresses, the Department of Health and Social Care will work closely with NHS England and the Ministry of Housing, Communities and Local Government to decide any further ICB mergers and boundary changes.

What plans his Department has made to address the health needs of those classified with severe ME/CFS while exploring the specialised very severe ME/CFS service.

The decision will be announced in due course. At this stage, officials from the Department and NHS England have been working carefully through the steps needed to make a decision on the prescription of a specialised service for very severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). My Rt. Hon. Friend, the Secretary of State for Health and Social Care, is responsible for a decision on the prescribing of specialised services, which requires consultation with NHS England.The Department is also developing a template service specification for mild and moderate ME/CFS, which also contains references to severe ME/CFS. Further work will need to be undertaken to strengthen support for people with severe ME/CFS, reflecting that people may move between moderate and severe. Future iterations of this document will build on these ongoing considerations and emerging insights.To support healthcare professionals in the diagnosis and management of ME/CFS, the Department has worked with NHS England to develop an e-learning programme on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes. The final module of this e-learning programme is focussed on improving understanding of severe ME/CFS in particular. All three sessions of the e-learning programme are now available at the following link:https://learninghub.nhs.uk/catalogue/mecfselearning?nodeId=7288

When his Department's proposed timeline is for announcing its decision on the prescription of a specialised service for Very Severe ME/CFS.

The decision will be announced in due course. At this stage, officials from the Department and NHS England have been working carefully through the steps needed to make a decision on the prescription of a specialised service for very severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). My Rt. Hon. Friend, the Secretary of State for Health and Social Care, is responsible for a decision on the prescribing of specialised services, which requires consultation with NHS England.The Department is also developing a template service specification for mild and moderate ME/CFS, which also contains references to severe ME/CFS. Further work will need to be undertaken to strengthen support for people with severe ME/CFS, reflecting that people may move between moderate and severe. Future iterations of this document will build on these ongoing considerations and emerging insights.To support healthcare professionals in the diagnosis and management of ME/CFS, the Department has worked with NHS England to develop an e-learning programme on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes. The final module of this e-learning programme is focussed on improving understanding of severe ME/CFS in particular. All three sessions of the e-learning programme are now available at the following link:https://learninghub.nhs.uk/catalogue/mecfselearning?nodeId=7288

What progress the MRS has made in delivering mechanistic research into ME/CFS.

We do not know what ‘MRS’ refers to in this context. The Department funds research through the National Institute for Health and Care Research (NIHR). A limited amount of mechanistic research is funded through the NIHR, but the majority of mechanistic research is funded through the Medical Research Council (MRC), a UK Research and Innovation Council sponsored by the Department for Science, Innovation and Technology. Mechanistic research into myalgic encephalomyelitis, also known as chronic fatigue syndrome, is within the remit of the MRC.

What assessment he has made of the potential merits of including medication for the treatment of Parkinson's disease in the medical exemption scheme.

I refer the Hon. Member to the answer I gave to the Hon. Member for Broxtowe on 20 January 2026 to Question 106198.

Whether he plans to review the adequacy of the GP Contract at reflecting (a) increases in demand, (b) inflation and (c) additional responsibilities.

General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking into account demand and the cost of delivering services. We have started the 2026/27 GP Contract consultation, and we look forward to listening to a range of stakeholders to help strengthen policy making, ensuring that GPs work for staff and patients.

What assessment has his Department made of the potential impact of ICB mergers on continuity and access in rural and semi-rural areas.

Across larger integrated care board (ICB) footprints there will be a renewed focus on the local level as part of our commitment to delivering care closer to home, and this includes rural and semi rural areas. As outlined in our 10-Year Health Plan, neighbourhood health plans will be created and will be brought together as part of the ICBs’ plans to improve population health locally.

What steps he is taking to help ensure that smaller systems, such as Gloucestershire, do not lose visibility or influence within larger merged ICBs which include urban centres.

Across larger integrated care board (ICB) footprints there will be a renewed focus on the local level as part of our commitment to deliver care closer to home. As outlined in our 10-Year Health Plan, neighbourhood health plans will be created, including for Gloucestershire, and will be brought together as part of the ICBs’ plans to improve population health locally.

What steps are his department taking to ensure the that upcoming GP Connect requirements support confidentiality and data integrity.

GP Connect helps clinicians to gain access to general practice (GP) patient records during interactions away from a patient’s registered practice and makes their medical information available to appropriate health and social care professionals when and where they need it, to support the patient’s direct care. From a privacy, confidentiality, and data protection perspective, GP Connect provides a method of secure information transfer and reduces the need to use less secure or less efficient methods of transferring information, such as email or telephone. Access to GP Connect is governed by role-based access and organisational controls, and only people who need to see the GP patient record for a patient’s direct care should be able to see it. Data integrity is ensured by the GP Connect Application Programming Interface sharing an accurate, consistent, and real time complete copy of specific data held in the source GP record. All systems that allow the use of GP Connect must undergo a robust compliance process. All organisations applying to use GP Connect must comply with the National Data Sharing Arrangement (NDSA) and end-user agreement that sets out their responsibilities and confidentiality obligations. Further information is available at the following link:https://digital.nhs.uk/services/gp-connect/national-data-sharing-arrangement-for-gp-connectThe NDSA and its terms and conditions stipulate that any information received or accessed about a patient for direct care purposes must remain confidential.NHS England has published a Privacy Notice and a Data Protection Impact Assessment for GP Connect, which can be found, respectively, at the following two links:https://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-privacy-notice/impact-assessmenthttps://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-privacy-notice

What mechanisms will ensure accountability for primary care outcomes within merged ICBs, particularly where decision-making is centralised elsewhere.

The NHS Oversight Framework will continue to provide the approach to assessing integrated care boards, including in relation to primary care.

What assessment has his department made of the potential impact of funding levels for primary care on levels of demand for secondary and urgent care.

We are investing an additional £1.1 billion in general practice (GP) to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26, which is the biggest cash increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole. Over 10 million more GP appointments have been delivered in the 12-months to September 2025 compared to the same period last year, building capacity and improving access so that patients can be seen when they need to be in primary care.As part of GP Contract funding, since 1 October, GPs must allow patients to contact them via an online form at any time during core hours to request an appointment or to raise a query, in addition to telephone and in-person requests. By expanding ease of contact via online access, we will reduce pressure on accident and emergency, as we know that many patients seek medical care in accident and emergency if they fail to make contact with their GP. We are also funding the expansion of Advice and Guidance to improve two-way communication between GPs and hospital specialists and to ensure care is delivered in the right setting. We expect this to increase the usage of Advice and Guidance and to help patients receive the care they need in primary and community settings where appropriate, reducing referrals to secondary care.

Whether his Department has considered guarantees on specialist care provision for Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) and very severe ME.

The commissioning of myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), services is the responsibility of local integrated care boards, based on the needs of their local population.The final delivery plan on ME/CFS, which we published in July, includes an action for the Department and NHS England to explore whether a specialised service should be prescribed by my Rt Hon. Friend, the Secretary of State for Health and Social Care, for very severe ME/CFS. Officials from the Department have commenced discussions with NHS England on how best to take forward this action.

How will GPs be supported with increases in workload demand for ADHD, gender medicine and weight-management prescribing.

We are investing an additional £1.1 billion in general practice (GP) to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26, which is the biggest cash increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.Since October 2024, we have funded primary care networks with an additional £160 million to recruit recently qualified GPs through the Additional Roles Reimbursement Scheme. Over 2,600 individual GPs have now been recruited, preventing them from graduating into unemployment. We have committed to training thousands more GPs across the country which will increase capacity and take the pressure off those currently working in the system.The Government is committed to ensuring the GP workforce is sustainable, supported, and valued for the work they do. Good staff experience is crucial in ensuring the NHS is able to recruit and retain staff and its importance is recognised and illustrated in the recently published 10-Year Health Plan. Later this year we will publish a 10 Year Workforce Plan which will ensure that staff will be better treated, have better training, more fulfilling roles, and hope for the future, so they can achieve more.The National Institute for Health and Care Excellence produces evidence-based guidance for health and care practitioners on best practice for a variety of conditions including attention deficit hyperactivity disorder and obesity. NHS England has also published service specifications that describe how clinical and medical care is offered to people with gender dysphoria.GPs have access to a range of support from their integrated care boards and NHS England has developed a suite of implementation materials, delivery guidance and protocols, and has provided access to training resources to help GPs with weight management prescribing.

Which department is responsible for making decisions and research into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) as part of the Final Delivery Plan.

The Department of Health and Social Care is responsible for the overall delivery of the final delivery plan on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The Department funds research through the National Institute for Health and Care Research (NIHR).To address the breadth of the ME/CFS research challenge, the NIHR and the Medical Research Council (MRC), part of UK Research and Innovation, play complementary roles in the United Kingdom landscape by funding research across the research system, with MRC funding aetiological and early-stage translational science and NIHR funding later stage translational and applied clinical work.The NIHR and MRC are working together to deliver the research actions outlined in the ME/CFS final delivery plan that we published in July.

Whether access metrics will be reviewed to ensure they support relationship-based care.

This Government values continuity in general practice (GP) and there is an incentive to identify those who would benefit from continuity in the GP contract, but this isn't inconsistent with efforts to improve access, such as via the 24 hour access target where urgent treatment is required.We are investing an additional £1.1 billion in general practice to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest cash increase in over a decade. The 8.9% boost to the GP contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.Over ten million more GP appointments have been delivered in the 12 months to September 2025 compared to the same period last year, building capacity for continuity of care and improving access so that patients can be seen when they need to be in primary care.In the 2025/26 GP contract, a new domain was introduced into the Capacity and Access Improvement Payment which incentivises primary care networks to risk stratify their patients in accordance with need including to identify those that would benefit most from continuity of care.

What assessment has his department made of the potential impact of access targets on continuity of care.

The Government values continuity in general practice, but this is not inconsistent with efforts to improve access, such as via the 24-hour access target where urgent treatment is required.In the 2025/26 contract, one of the domains of the Capacity and Access Improvement Payment, worth £29.2 million, incentivises primary care networks to risk stratify their patients in accordance with need for continuity. This allows general practitioners (GPs) to deliver care to meet the specific needs of their patients.We are investing an additional £1.1 billion in GPs to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.4 billion in 2025/26, which is the biggest cash increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the National Health Service budget as a whole.Over ten million more GP appointments have been delivered in the 12 months to September 2025 compared to the same period last year, building capacity for continuity of care and improving access so that patients can be seen when they need to be in primary care. Patient satisfaction with access has improved significantly, rising from 61% in July 2024 to 74% in July 2025, marking a 13-percentage-point increase over the last year.