Written questions by Martin.

What discussions his Department has had with the National Institute for Health and Care Excellence on the use of encorafenib in combination with cetuximab and chemotherapy as a first‑line treatment for patients with BRAF V600E‑mutated metastatic colorectal cancer, in light of the results of the phase III BREAKWATER trial.

Awaiting answer.

What steps his Department is taking to ensure that neurodevelopmental assessments for children, including assessments for autism and ADHD, are carried out to an adequate and consistent standard across England, in line with NICE guidance, and that such assessments involve appropriate multidisciplinary input and sufficient direct observation of the child.

The Government has recognised that, nationally, demand for assessments for autism and attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays for accessing such assessments. The Government’s 10-Year Health Plan will make the National Health Service fit for the future, recognising the need for early intervention and support.It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to autism and ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for people referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and following a recent diagnosis of autism. Since publication, NHS England has been supporting systems and services to identify where there are challenges for implementation and how they might overcome these.NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.The Medium-Term Planning Framework, published 24 October, was explicit that ICBs and providers are expected to optimise existing resources to reduce long waits for ADHD and autism assessments and improve the quality of assessments by implementing existing and new guidance, as published.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 the prevalence and support for mental health conditions, ADHD, and autism. This independent review will inform our new approach to mental health so people receive the right support, at the right time and in the right place. Likewise, the review will inform our approach so that people with ADHD and autistic people have the right support in place to enable them to live well in their communities.

What recent assessment he has made of the potential merits of expanding NHS IVF funding criteria to cover individuals whose infertility results directly from medically necessary procedures, such as hysterectomy.

No recent assessments have been undertaken by the Department.Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their local population. We expect these organisations to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.NICE is currently reviewing the fertility guideline and will consider whether its current recommendations for access to National Health Service-funded treatment are still appropriate. The draft guidance was consulted on between 10 September and 21 October 2025, and final guidance is expected to be published in March 2026. We expect ICBs to consider and reflect the updated NICE fertility guideline in their commissioning decisions when it is published, and we are working with NHS England to support greater consistency in provision.

Whether he plans to extend NHS eligibility for the Shingrix shingles vaccine to older adults who previously received Zostavax.

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent departmental expert committee which advises the Government on matters related to vaccination and immunisation. In November 2024, the JCVI provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over, regardless of whether these older individuals have previously been eligible for, or have been vaccinated with, Zostavax. The Department is carefully considering this advice as it sets the policy on who should be offered shingles vaccinations.

What assessment he has made of the potential impact on patients with relapsed or refractory Mantle Cell Lymphoma of NICE’s draft decision not to recommend brexucabtagene autoleucel (Tecartus) for NHS use; and whether he plans to review the CAR‑T delivery tariff to ensure continued access to treatments.

The National Institute for Health and Care Excellence (NICE) is currently re-evaluating brexucabtagene autoleucel to determine whether it can be recommended for routine National Health Service funding following a period of managed access through the Cancer Drugs Fund. NICE’s draft guidance, published in December, does not recommend it as a clinically and cost-effective use of NHS resources. The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients with mantle cell lymphoma will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.The CAR-T delivery tariff reflects the costs which the NHS incurs for delivering CAR-T therapy. The tariff was updated for the start of the 2024/25 financial year following a planned costing review involving all CAR-T providers in England. This enabled the tariff to be updated with the benefit of the significant delivery experience that can be drawn on having first routinely introduced CAR-T in the NHS in 2023. Other than considering an appropriate inflationary uplift on an annual basis, in line with usual practice, there are no plans to further review the tariff at this time. Other CAR-T therapies have been recommended for routine NHS adoption in England by NICE based on an assessment of clinical and cost effectiveness that reflects the existing CAR-T delivery tariff, most recently obecabtagene autoleucel for acute lymphoblastic leukaemia.

What steps he is taking support patients with Functional Neurological Disorder (FND), and what assessment he has made of the potential merits of establishing a pathway of care and treatment from diagnosis of FND.

In August, NHS England updated the Specialised Neurology Service Specification, which is available at the following link:https://www.england.nhs.uk/publication/specialised-neurology-services-adults/The updated service specification includes specific reference to functional neurological disorder (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.In October 2025, the National Institute for Care Excellence (NICE) published guidance on rehabilitation for chronic neurological disorders, including acquired brain injury, with the reference code NG252. This guidance includes FND within its scope.There are also 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 Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England.There are a number of policies outlined in the 10-Year Health Plan which should have a positive impact on care for patients with FND. More tests and scans delivered in the community, better joint working between services, and greater use of technology will all support people to manage FND closer to home.

What assessment he has made of the potential impact of mandatory folic acid fortification on people with MTHFR gene variants.

The Government’s policy to mandate the fortification of non-wholemeal wheat flour with folic acid is aimed at reducing the incidence of neural tube defects (NTDs) in pregnancy. This policy is based on robust assessment of the evidence by the UK Scientific Advisory Committee on Nutrition (SACN) and has included two public consultations.The SACN’s assessment included consideration of individuals with a specific MTHFR gene variant that reduces their ability to process folate from their diet resulting in lower levels of folate in their blood. The two public consultations invited feedback from a wide range of stakeholders, which included individuals concerned about MTHFR gene variants.An increased intake of folic acid will raise blood folate levels, which reduces the risk of an NTD-affected pregnancy. Therefore, mandatory folic acid fortification is likely to be beneficial to individuals with the specific MTHFR gene variant.The Government is exploring options to evaluate the policy, which will assess health impacts across different population groups.

What steps his Department is taking to review workforce speciality training allocations in the NHS; and if he will take steps to increase the number of (a) training posts and (b) permanent positions for newly qualified doctors in (i) General Practice, (ii) sexual health, (iii) haematology specialties and (iv) other positions.

As set out in our 10-Year Health Plan, published on 3 July, we will work across the Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training. The Plan also sets out that over the next three years we will create 1,000 new specialty training posts with a focus on specialties where there is greatest need.In acknowledgement of doctors’ concerns about jobs and access to training places, the Government made an offer to the British Medical Association’s Resident Doctors Committee to double the previously announced increase in specialty training places in the 10-Year Health Plan to 2,000, bringing 1,000 of these forward to next year, create an alternative training pathway, and take steps to prioritise UK medical graduates and doctors with significant NHS experience for specialty posts. The new specialty training posts will focus on specialties where there is greatest need. On top of this commitment, NHS England has already made changes to the specialty training application process this year to reduce competition and support UK graduates.The Government has committed to training thousands more general practitioners (GPs) and has increased the number of available GP training places by an additional 250 from September 2025. This brings the total number of GP training places to 4,250 per year.As self-employed contractors to the NHS, it is for GPs to determine how they run their operations, including staffing arrangements.We are investing an additional £1.1 billion in GPs 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 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 2,500 individual GPs have now been recruited, preventing them graduating into unemployment. This was a measure to respond to feedback from the profession and to help solve an immediate issue of GP unemployment.

If he will make an assessment of the potential merits of mandating restaurants in England to display their food hygiene rating.

The Food Hygiene Rating Scheme is operated by the Food Standards Agency (FSA) in partnership with local authorities across England, Wales, and Northern Ireland. Evidence from Wales and Northern Ireland demonstrates that mandatory display has improved transparency, which encourages businesses to achieve better levels of compliance with hygiene requirements.Introducing a statutory scheme in England with mandatory display of ratings at premises and online, would require primary legislation and the securing of a suitable legislative vehicle and parliamentary time. Ministers will consider the options in due course supported by the FSA.In the meantime, the FSA is continuing to work with its local authority partners to deliver an excellent Food Hygiene Rating Scheme.

Whether his Department is taking steps to (a) review and (b) update the guidance entitled Children and young people’s continuing care national framework, published on 22 January 2016.

The National Framework for Children and Young People’s Continuing Care, published by the then Department of Health, now the Department of Health and Social Care, in January 2016 is intended to support good practice locally, providing guidance for integrated care boards (ICBs) and local authorities on the process for assessing, deciding, and agreeing packages of care for children and young people.There are currently no plans to review or update the Children and Young People's Continuing Care National Framework. ICBs are responsible for the provision and commissioning of services to meet the needs of their local populations. NHS England supports ICBs to implement the National Framework for Children and Young People’s Continuing Care, and it has now started to collect Children and Young People’s Continuing Care activity data as part of the All-age Continuing Care Patient Level Dataset which launched on 1 April 2025, and which is available at the following link: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/all-age-continuing-care-data-set/about-the-all-age-continuing-care-data-set

How many newly qualified nurses have secured employment through the Graduate Guarantee scheme since its introduction; what assessment he has made of the effectiveness of the Graduate Guarantee scheme; and with reference to the forthcoming 10 Year Workforce Plan, what steps his Department is taking to align the number of nursing graduates with the availability of entry-level posts.

Supporting newly qualified nurses and midwives to move smoothly into employment is a key priority. The Graduate Guarantee, introduced in August 2025, is now being implemented across the National Health Service to ensure every newly qualified nurse and midwife is supported to secure appropriate employment. Early feedback from trusts and regions indicates that it is having a positive impact on the current recruitment cycle, with organisations recruiting ahead of turnover and creating additional entry-level posts.We expect the recruitment cycle to be concluded by March 2026 for this cohort, and published workforce statistics will provide a transparent assessment of the current NHS workforce. The forthcoming Chief Nursing Officer professional strategy for nursing and midwifery, alongside the 10 Year Workforce Plan, will set out further details on future workforce needs.

What steps his Department is taking to ensure newly qualified nurses can access Band 5 roles in their local area; and what assessment he has made of the potential impact of (a) experience requirements and (b) internal-only job advertisements on newly qualified nurses' ability to secure employment.

Newly qualified nurses are an essential part of the National Health Service workforce, and it is important that they are able to access suitable Band 5 employment opportunities on qualification. The Graduate Guarantee, introduced in August 2025, is now being implemented across the NHS to ensure every newly qualified nurse and midwife is supported to secure appropriate employment. Early feedback from trusts and regions indicates it is having a positive impact on the current recruitment cycle, with organisations recruiting ahead of turnover and creating additional entry-level posts.In parallel, all regions are working with providers and higher education institutions to ensure a smooth transition from training into employment for newly qualified nurses with students being invited to apply for local roles. NHS England has also reminded employers to ensure advertisements do not disadvantage newly qualified nurses seeking their first post.

When the Minister for Secondary Care plans to respond to the correspondence of 28 July 2025 from the hon. Member for Tunbridge Wells on the Dashboard for Accelerated Discharge.

I have received the hon. Member’s correspondence and will reply in due course.

What assessment he has made of the potential merits of expanding the scope of the maternity care inquiry to include the limitations of coroners’ powers to hold inquests into stillbirths.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, recently announced an independent, national investigation into National Health Service maternity and neonatal services, to look at the systemic issues behind why so many women, babies, and families experience unacceptable care. It will look at up to 10 maternity and neonatal units where there are specific issues, international evidence, adoption of best practice, and will engage in a system-wide investigation of maternity and neonatal care. This will include bringing together lessons from past reviews. The investigation will produce, by December 2025, one clear set of national recommendations to achieve high quality, safe care across maternity and neonatal services, and will ensure that women and families are listened to.My Rt Hon. Friend, the Secretary of State for Health and Social Care, also announced the establishment of a Maternity and Neonatal Taskforce that will use the recommendations from the independent investigation to develop a national plan with families to drive improvements across maternity and neonatal care.The Terms of Reference for the independent investigation and taskforce, including the investigation’s scope, are being developed with input from families and other key partners and are expected to be published shortly. We are not, therefore, able to confirm whether this will include reference to coronial powers.

When he plans to respond to the correspondence from the hon. Member for Tunbridge Wells on coroners holding inquests into stillbirths, dated 6 June 2025.

The Department has received the Hon. Member’s correspondence of 6 June and will reply as soon as possible.

What information he holds on the number of patients waiting longer than the Kent Integrated Dermatology Service's four week deadline for issuing biopsy results, in each of the last six months.

The Department does not hold information on the number of patients waiting longer than four weeks for their biopsy results.The Government is spending £600 million of capital this year on diagnostics, including funding for the automation of histopathology laboratories, for the first time ever, to improve productivity. We are also funding all pathology networks to increase digital capabilities by March 2026, which will reduce unnecessary waits and repeat tests, to ensure that patients receive their results sooner, including those in Kent.

What steps his Department is taking to improve ambulance response times in Tunbridge Wells.

The Government recognises the pressures on the National Health Service and the impact this is having on ambulance response times, including in Tunbridge Wells.We are determined to turn things around, and our 10-Year Health Plan will be published in the summer, setting out major NHS reforms to move healthcare from the hospital to the community, from analogue to digital, and from sickness to prevention.The NHS Urgent and Emergency care plan 2025/26, published on 6 June 2025, requires health systems to focus on those areas likely to have the biggest impact on urgent and emergency care services this year. The plan includes actions that will reduce category 2 ambulance response times to 30 minutes and reduce ambulance handovers to 45 minutes, helping to get 550,000 more ambulances back on the road.

If he will take steps to review regional differences in the (a) diagnosis, (b) treatment and (c) ongoing care for people with coeliac disease across NHS services in England.

Most services for long-term conditions, including for people with coeliac disease, are commissioned locally by integrated care boards (ICBs). It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that meet patients’ needs. The Government expects ICBs to take account of relevant guidelines and best practice in designing their local services, and to ensure consistency of approaches between ICBs.The National Institute for Health and Care Excellence (NICE) publishes guidance on the diagnosis and treatment of conditions for use by healthcare professionals and commissioners in England. NICE guidelines are not mandatory and do not replace the judgement of clinicians in determining the most appropriate treatment for individual patients.The NICE guideline, Coeliac disease: recognition, assessment and management, published in 2015 and reviewed in 2019, is available at the following link:https://www.nice.org.uk/guidance/ng20The NICE also publishes clinical knowledge summaries (CKS) as a source of information mainly for national Health Service staff working in primary care. A CKS on the clinical management of coeliac disease, which was last revised in May 2020, is available at the following link:https://cks.nice.org.uk/topics/coeliac-disease/We have launched a 10-Year Health Plan to reform the NHS and improve care for people, including those with long-term conditions like coeliac disease. A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we provide the staff, technology, and infrastructure the NHS needs to make it more accessible, proactive, and tailored for patients wherever they live in England.

What steps he is taking to help improve access to NHS services for deaf people.

Integrated care boards are responsible for commissioning services to meet the needs of their local population, including deaf people.Under the Equality Act (2010), health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. The Reasonable Adjustment Digital Flag was developed in the National Repository to enable health and care workers to record, share, and view details of reasonable adjustments, across the National Health Service and social care, wherever the person is seen or treated. Following the launch of the Reasonable Adjustment Digital Flag Information Standard, published September 2023, the flag went live in the National Care Record Service and is being rolled out across England. Since 2016, all NHS organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the recommended approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss, including deaf people. NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force and therefore there should not be a gap in provision for people using services.

What steps his Department is taking to improve the quality of wound care, in the context of the disbandment of the National Wound Care Strategy Programme in March 2025.

The outcome of the National Wound Care Strategy Programme was to implement consistently high wound care across England by reducing unnecessary variation, improving safety, and optimising patient experience and outcomes.NHS England’s work on wound care has now transitioned into its business as usual service, and work is continuing to support the spread of best practice across England. Additionally, to further improve the quality of wound care, a pressure ulcer improvement diagnostic and discovery phase of work was agreed as a priority component of the national wound care programme, undertaken in partnership with the National Wound Care Strategy Programme team, the National Nursing Directorate, providers, and integrated care systems.Resources developed through the National Wound Care programme are accessible on the NHS Futures website.