Written questions by Wilkinson.

If he will consider reviewing the geographical areas within which resident doctors are expected to relocate during specialty training.

We recognise the importance of location stability for doctors in training and the impact that frequent relocations can have on wellbeing, retention, and workforce planning.A review into postgraduate medical training is already underway. The first phase of the review has now concluded, with further information available at the following link:https://www.england.nhs.uk/publication/the-medical-training-review-phase-1-diagnostic-report/The next phase of the review will involve working with a wide range of stakeholders across the system to design a package of reform.Alongside this review, a review of rotational training is currently in progress and is being led by the Department, along with NHS England and the British Medical Association.NHS England’s 10 Point Plan to improve resident doctors’ working lives, published on 29 August, contains a commitment to reduce the impact of rotations upon resident doctors’ lives while maintaining service delivery. Further information can be found at the following link:https://www.england.nhs.uk/long-read/10-point-plan-to-improve-resident-doctors-working-lives/

What assessment his Department has made of the capacity of GP services in Gloucestershire to meet patient demand.

We are expanding capacity in general practice, enabling more appointments for patients both nationally and in Gloucestershire.Gloucestershire Integrated Care Board has achieved a 6.4% increase in appointments delivered in general practice since 2024, with 398,000 appointments provided in September 2025 compared to 374,000 in September 2024.In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of an additional 2,500 GPs into Primary Care Networks across England. This has helped to increase appointment availability and improve care for thousands of patients. We have invested an additional £1.1 billion in general practice to reinforce the front door of the National Health Service which was the biggest increase in over a decade. Additionally, we have invested £102 million into the Primary Care Utilisation and Modernisation Fund which will create additional clinical space within over 1,000 GP practices across England and will help deliver more appointments each year.

What assessment his Department made of the potential impact of unlimited online consultations, introduced in the new GP contract, on the ability of GPs to meet patient demand.

In February 2025 the GPCE agreed to make it a contractual obligation for all GP practices to offer access to online services throughout core hours (8:00am - 18:30pm), bringing online access in line with walk-in and phone access. To support practices in preparing for this transition and to ensure they had sufficient time to make the necessary adjustments, the start date was deferred to 1 October 2025.This change aims to improve patient access, reduce long phone queues, and help general practitioners manage demand more effectively. Experience suggests that extending online access offers significant benefits to both patients and practices. With more patients using online options, phone lines will be less busy and will open up availability for those who need additional help or more urgent care.We understand that practices require additional resource to deliver services to their patients. That is why we have invested £1.1 billion into general practice: £160 million of this to expand the GP workforce (adding 2,000 more GPs since October 2024), and £102 million to create more clinical space which will enable the delivery of 8.3 million extra appointments.

What assessment his Department has made of the potential impact of offering free flu vaccines to (a) charity and (b) voluntary workers on the health of vulnerable people.

Eligibility for a free National Health Service flu vaccine is guided, each year, by advice and recommendations from the independent Joint Committee on Vaccination and Immunisation (JCVI) and is kept under regular review. The aim of the flu vaccination programme is to protect those most at risk from serious illness and hospitalisation.Those eligible to receive a free flu vaccine on the NHS this autumn are:pregnant womenall children aged 2 or 3 years on 31 August 2025children with certain long-term health conditions (aged 6 months to less than 18 years)primary school aged children (from reception to Year 6)secondary school aged children (from Year 7 to Year 11)all children in clinical risk groups aged from 6 months to under 18 yearseveryone aged 65 years and overindividuals aged 18 to under 65 with certain long-term health conditionscare home residentscarers in receipt of carer's allowance, or those who are the main carer of an elderly or disabled personthose living with people who are immunocompromisedfrontline health and social care workersThe NHS website contains further information on eligibility, which is available at the following link:https://www.nhs.uk/vaccinations/flu-vaccine/Anyone who feels unsure about their eligibility (including those who work with vulnerable people in a voluntary capacity) can consult their general practitioner, practice nurse, or pharmacist. Pregnant women can also consult their midwife.

Whether his Department plans to reopen the Aveta Birth Centre at Cheltenham General Hospital.

The national review and the local needs assessment processes will help in setting out ideas on how services could be developed. The trust and the integrated care board (ICB) are keen that any proposals for future service development are co-designed through meaningful engagement.The maternity health needs assessment at the Gloucestershire Hospitals NHS Foundation Trust is under way, led by the NHS Gloucestershire ICB. The needs assessment involves a review of nationally available data and trends, and the evidence base for what works in terms of quality and safety. NHS England is aligning its maternity needs assessment with national priorities to improve outcomes and experiences, particularly by tackling health inequalities.As part of the maternity needs assessment, NHS England is gathering insights from women and staff, asking about their experiences and their ideas for how services could be developed in the future.NHS England is in the process of agreeing a timeline for approval of the needs assessment, with final publication expected in Spring 2026.No plan to reopen the Aveta Birth Centre will be made until the outcome of the Government's Independent National Maternity Investigation, and the local Health Needs Assessment, led by the NHS Gloucestershire ICB and exploring the needs and changes in maternity care for Gloucestershire, are published. These are both due to report in Spring 2026.

What Gloucestershire Hospitals NHS Foundation Trust's planned timetable is for the (a) commencement and (b) publication of its health needs review.

The national review and the local needs assessment processes will help in setting out ideas on how services could be developed. The trust and the integrated care board (ICB) are keen that any proposals for future service development are co-designed through meaningful engagement.The maternity health needs assessment at the Gloucestershire Hospitals NHS Foundation Trust is under way, led by the NHS Gloucestershire ICB. The needs assessment involves a review of nationally available data and trends, and the evidence base for what works in terms of quality and safety. NHS England is aligning its maternity needs assessment with national priorities to improve outcomes and experiences, particularly by tackling health inequalities.As part of the maternity needs assessment, NHS England is gathering insights from women and staff, asking about their experiences and their ideas for how services could be developed in the future.NHS England is in the process of agreeing a timeline for approval of the needs assessment, with final publication expected in Spring 2026.No plan to reopen the Aveta Birth Centre will be made until the outcome of the Government's Independent National Maternity Investigation, and the local Health Needs Assessment, led by the NHS Gloucestershire ICB and exploring the needs and changes in maternity care for Gloucestershire, are published. These are both due to report in Spring 2026.

What steps his Department has taken to ensure that the third-party data entry of NHS patient data is processed securely.

IT systems in the National Health Service operate to the highest standards of security, and all organisations have governance arrangements in place to ensure the safe, legal management of data. Third party organisations operate under the instruction of the NHS when processing data, with safeguards in place to keep people’s confidential information secure as per contractual requirements. All organisations that have access to NHS patient data and systems must use the Data Security and Protection Toolkit (DSPT) to provide assurance on an annual basis that they are practising good data security and that personal information is handled correctly. Over 61,500 organisations completed a DSPT assessment for 2024/25.The privacy and confidentiality of health and care data is championed by the National Data Guardian who provides independent advice on the use of such data and holds the Caldicott Principles, which provide a framework for the safe and respectful use of data.

What assessment his Department has made of the adequacy of the capacity of GP services to meet demand in Gloucestershire.

We are expanding capacity in general practice, which will help to deliver more appointments to patients across the country, including in Gloucestershire. In October 2024, we invested £160 million into the Additional Roles Reimbursement Scheme to support the recruitment of an additional 2,000 general practitioners into primary care networks across England, helping to increase appointment availability and improve care for thousands of patients. We have invested an additional £1.1 billion in general practices to reinforce the front door of the National Health Service. This is the biggest increase in over a decade. Additionally, the new £102 million Primary Care Utilisation and Modernisation Fund will create additional clinical space within over 1,000 general practices across England to deliver 8.3 million more appointments each year. In the 12 months to August 2025, 4.74 million appointments were delivered in the Gloucestershire Integrated Care Board, which is a 3.2% increase from the previous year.

What assessment his Department has made of the potential impact of unlimited online consultations on the ability of GPs to meet patient demand.

From 1 October, we extended access to general practice (GP) online services throughout core hours, which are from 8:00am to 18:30pm. According to the Office for National Statistics, for the first time ever, more patients are contacting their GP online rather than by phone, at 42.3% and 41.3% respectively. For GPs already offer online services, we are asking them to extend this service throughout core hours to bring online access in line with walk-in and phone access. GPs already using online systems have seen big improvements. One London GP surgery reduced waits from 14 days to just three, with 95% of patients seen within a week. The National Health Service continues to support those practices needing assistance with implementing these changes.We understand that practices require additional resource to deliver services to their patients. That’s why we have invested £1.1 billion into GPs, with £160 million of this to expand the GP workforce, which has added 2,000 more GPs since October 2024, and £102 million to create more clinical space which will enable the delivery of 8.3 million extra appointments.

What assessment his Department has made of the potential impact of the severity modifier criteria on access to drugs for cancer patients.

The National Institute for Health and Care Excellence (NICE) has been monitoring the impact of the severity modifier since it was implemented in 2022. Data up to March 2025 shows that the proportion of positive cancer recommendations is higher (85%) than with the end-of-life modifier it replaced (75%) and the proportion of positive recommendations for advanced cancer treatments is also higher (81% compared to 69%).Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed, including treatments for advanced breast cancer (such as Truqap and Korserdu), which are now available to eligible National Health Service patients.The severity modifier is therefore working as intended and there are currently no plans to adjust or change it in the near future. However, NICE has commissioned research on people’s attitudes to how the severity modifier should be applied that will inform future reviews of NICE’s methods.

What assessment his Department has made of the potential impact of NICE's decision to restrict secondary breast cancer patient's access to Enhertu on the grounds of patient wellbeing.

The National Institute for Health and Care Excellence (NICE) makes independent, evidence-based recommendations for the National Health Service in England on whether new licensed medicines should be routinely funded for eligible patients based on an evaluation of clinical and cost effectiveness.NICE has recommended Enhertu, also known as trastuzumab deruxtecan, for use in the Cancer Drugs Fund for the treatment of women with HER2-positive secondary breast cancer and it is now available for the treatment of eligible patients while further data on its effectiveness is being collected that will inform a NICE decision on routine funding.NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca and Daiichi Sankyo in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance published in July 2024 will therefore remain unchanged. NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.

What steps his Department is taking to ensure the provision of specialist (a) wheelchairs, (b) beds and (c) armchairs for tall disabled people.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services. National Health Service trusts work with the patient and wheelchair supplier to best meet the patient’s needs and requirements.A typical hospital bed is 200 centimetres long and can be extended by 20 centimetres with pressure relieving infills available. With regards to armchairs, the NHS Supply Chain works with customers and suppliers if any bespoke products are needed in the market.Equipment provision, where required for use in peoples’ own homes, is typically through a community equipment service; these are usually funded through a combination of the local authority and local NHS and provided via an outsourced provider or a locally-run service.

What assessment he has made of the adequacy of levels of pay for resident doctors.

The Government allows the independent Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to make recommendations on headline pay for doctors, including resident doctors. Within their report they make an assessment on the level of pay with regard to various factors such as recruitment and retention.We received the latest DDRB report at the end of April and on 22 May 2025, the Government announced the 2025/26 pay awards for National Health Service staff in England. The Government accepted the headline pay recommendations of the DDRB, which meant that resident doctors were awarded an, on average, 5.4% uplift to pay.My Rt Hon. Friend, the Secretary of State for Health and Social Care has held several meetings with the British Medical Association’s Resident Doctors Committee chairs to discuss pay and wider working conditions since the report was received.Resident doctors received the highest pay award of the entire public sector this year, an average 28.9% pay rise compared to three years ago.The process for the 2026/27 pay round is already underway, with the Department setting out the remit to the DDRB in July. The DDRB report, which was submitted earlier this year, is available at the following link:https://www.gov.uk/government/publications/review-body-on-doctors-and-dentists-remuneration-fifty-third-report-2025

What assessment his Department has made of the potential merits of conducting efficiency savings to fund more (a) clinical staff and (b) equipment in the NHS.

NHS England’s 2025/26 priorities and operational planning guidance made it clear that the National Health Service must live within the budget it is allocated, reduce waste and increase productivity to deliver growth against demand. The Autumn Statement 2024 reaffirmed a 2% NHS productivity growth target for 2025/26, and the recent Spending Review set out the commitment to achieve 2% productivity growth across the Spending Review period, supported by up to £10 billion of technology and digital investment.As part of the 2025/26 planning process, all NHS systems set efficiency and savings targets necessary to achieve a balanced financial position, and planned delivery of the other national priorities set out in planning guidance including recovering elective activity. To help organisations identify savings and plan for 2025/26, NHS England shared core productivity and efficiency metrics with benchmarked opportunities. For a given budget, savings and productivity opportunities can enable the same level of clinical staff to do more activity, or can involve savings to non-clinical areas or reduction in input costs, for example, procurement and agency savings, to enable reinvestment in additional clinical staff or non-capitalised equipment.

How many GPs have (a) been hired and (b) left practice since July 2024.

Between June 2024 and June 2025, the most recent period for which data is available, 2,611 full time equivalent (FTE), or 4,174 headcount, fully qualified general practitioners (GPs) joined general practice, while 1,760 FTE, or 2,756 headcount, fully qualified GPs left general practice.

What funding his Department has allocated to GP practices to hire more GPs.

We are starting to see consistent growth in the general practitioner (GP) workforce.  In July 2025, there were 658 more fully qualified full-time equivalent GPs working in practices than in July 2024.The Government committed to recruiting over 1,000 recently qualified GPs in primary care networks (PCNs) through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25. This is part of our initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified general practitioners for which PCNs are claiming reimbursement via the ARRS show that, since 1 October 2024, over 2,000 GPs were recruited through the scheme.Newly qualified GPs employed under the ARRS will continue to receive support under the scheme in the coming year as part of the 25/26 contract. Several changes have been confirmed to increase the flexibility of ARRS. These include: GPs and practice nurses included in the main ARRS funding pot; an uplift of the maximum reimbursable rate for GPs in the scheme; and no caps on the number of GPs that can be employed through the scheme.We are boosting practice finances by investing an additional £1,092 million in general practice to reinforce the front door of the NHS, bringing total spend on the GP contract to £13.4 billion in 2025/26. This is the biggest increase in over a decade. The 8.9% boost to the GP contract in 2025/26 is faster than the 5.8% growth to the NHS budget as a whole.

What recent steps his Department has taken to increase the recruitment of GPs.

We are starting to see consistent growth in the general practitioner (GP) workforce.  In July 2025, there were 658 more fully qualified full-time equivalent GPs working in practices than in July 2024.The Government committed to recruiting over 1,000 recently qualified GPs in primary care networks (PCNs) through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25. This is part of our initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified general practitioners for which PCNs are claiming reimbursement via the ARRS show that, since 1 October 2024, over 2,000 GPs were recruited through the scheme.Newly qualified GPs employed under the ARRS will continue to receive support under the scheme in the coming year as part of the 25/26 contract. Several changes have been confirmed to increase the flexibility of ARRS. These include: GPs and practice nurses included in the main ARRS funding pot; an uplift of the maximum reimbursable rate for GPs in the scheme; and no caps on the number of GPs that can be employed through the scheme.We are boosting practice finances by investing an additional £1,092 million in general practice to reinforce the front door of the NHS, bringing total spend on the GP contract to £13.4 billion in 2025/26. This is the biggest increase in over a decade. The 8.9% boost to the GP contract in 2025/26 is faster than the 5.8% growth to the NHS budget as a whole.

What his Department's planned timetable is for increasing the annual provision of specialty training places for resident doctors.

As set out in the 10-Year Health Plan published in July 2025, over the next three years we will create 1,000 new specialty training posts with a focus on specialties where there is greatest need. We will set out next steps in due course

What steps he is taking to review NHS outsourcing contracts.

All public authorities, including the National Health Service, follow the guidance and principles set out in the Sourcing Playbook when planning and making sourcing decisions to deliver public services in partnership with the private and third sectors. The playbook is available at the following link:https://www.gov.uk/government/publications/the-sourcing-and-consultancy-playbooksThe consultation, Public Procurement: Growing British industry, jobs and skills, is one considering further reforms to public procurement. More specifically, it is proposed that public bodies would be required to carry out a quick and proportionate public interest test, to understand whether that work could not be more effectively done in-house before any service is contracted out. The Cabinet Office will consider the results of the consultation, and the Department will comply with any changes to the law. Details of the consultation are available at the following link: https://www.gov.uk/government/consultations/public-procurement-growing-british-industry-jobs-and-skills-consultation-on-further-reforms-to-public-procurement/public-procurement-growing-british-industry-jobs-and-skills-html

What steps he is taking to deliver a pay restoration framework for resident doctors.

Each year the Government allows the independent Doctors’ and Dentists’ Review Body (DDRB) to make recommendations on headline pay for doctors, including resident doctors.In May 2025, the Government announced the 2025/26 pay awards for National Health Service staff in England, accepting the headline pay recommendations of the DDRB, for consultants, specialty and specialist doctors, and resident doctors for the 2025/26 period.Resident doctors received one of the highest pay awards of the entire public sector this year, meaning an average 28.9% pay rise compared to three years ago.The DDRB has been remitted and the process for 2026/27 pay is already under way.