Written questions by Harding.

How many community pharmacies have closed in (a) Surrey and (b) Esher and Walton constituency in each year since 2019.

Since 2019, there have been a total of 39 pharmacy closures in Surrey, and four in the Esher and Walton Constituency. In Surrey, this has broken down as: seven closures in 2019; six in 2020; four in 2021; two in 2022; and 15 in 2023, with a further five having closed between January and 30 September 2024. In Esher and Walton, there were no closures between 2019 and 2022. Three closed in 2023, and one closed between January and 30 September 2024.We are aware of the reduction in the number of pharmacies in recent years, and recognise that pharmacy closures can impact on local communities. Local authorities are required to undertake a pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served, and must keep these assessments under review. Integrated care boards give regard to the PNAs when reviewing applications from the new contractors. Contractors can also apply to open a new pharmacy to offer benefits to patients that were not foreseen by the PNA.Patients can also access the approximately 400 Distance Selling Pharmacies who must operate nationally and send medicines to patients’ home free of charge. In rural areas, dispensing doctors can also supply medicines.

What assessment his Department has made of the potential impact of community pharmacy closures on (a) local health provision and (b) patient outcomes in (i) England and (ii) Surrey.

Since 2019, there have been a total of 39 pharmacy closures in Surrey, and four in the Esher and Walton Constituency. In Surrey, this has broken down as: seven closures in 2019; six in 2020; four in 2021; two in 2022; and 15 in 2023, with a further five having closed between January and 30 September 2024. In Esher and Walton, there were no closures between 2019 and 2022. Three closed in 2023, and one closed between January and 30 September 2024.We are aware of the reduction in the number of pharmacies in recent years, and recognise that pharmacy closures can impact on local communities. Local authorities are required to undertake a pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served, and must keep these assessments under review. Integrated care boards give regard to the PNAs when reviewing applications from the new contractors. Contractors can also apply to open a new pharmacy to offer benefits to patients that were not foreseen by the PNA.Patients can also access the approximately 400 Distance Selling Pharmacies who must operate nationally and send medicines to patients’ home free of charge. In rural areas, dispensing doctors can also supply medicines.

For which local authorities her Department has provided (a) support and (b) intervention for safety valve agreements since 2019.

The department has made Safety Valve agreements with 38 local authorities. These are: Bath and North East Somerset, Barnsley, Bexley, Blackpool, Bolton, Bracknell Forest, Bristol, Bury, Cambridgeshire, Croydon, Darlington, Devon, Dorset, Hammersmith and Fulham, Haringey, Hillingdon, Hounslow, Isle of Wight, Kent, Kingston upon Thames, Kirklees, Medway, Merton, Norfolk, North Somerset, North Tyneside, Richmond upon Thames, Rotherham, Salford, Slough, South Gloucestershire, Southwark, Stoke-on-Trent, Surrey, Torbay, Wiltshire, Wokingham and York. All agreements are published on GOV.UK and can be accessed at: https://www.gov.uk/government/publications/dedicated-schools-grant-very-high-deficit-intervention.Of these, five agreements are currently suspended. The local authorities with suspended agreements are Bath and North East Somerset, Cambridgeshire, Dorset, Hillingdon and Norfolk.All Safety Valve local authorities receive ongoing support through the monitoring process.

Food and Rural Affairs, what flood (a) prevention and (b) relief measures have been put in place to support communities along the Thames between Weybridge and Long Ditton in the event of flooding in winter 2024-25.

Following Storm Henk, the Environment Agency (EA) has undertaken a significant amount of debris clearance on weir structures, including the removal of a number of sunken & stricken vessels. The cost of the clean-up operation undertaken by our teams and supply chain partners has been more than £1 million over the last 6 months. The main flood risk reduction plan currently being developed along this area is the proposed River Thames Scheme (RTS). It is a partnership between the EA, Surrey County Council and other local partners, that will reduce the risk of flooding for communities from Staines to Teddington, including between Weybridge and Long Ditton. This will be achieved through the creation of a new flood channel, in two parts, and capacity improvements to Sunbury, Molesey and Teddington weirs on the Thames and to the river in the Desborough area. RTS will reduce flood risk to around 11,000 homes and 1,600 businesses. The EA are also looking at how to reduce the impact of flooding in Thames Ditton. Measures under consideration include raised barriers and property flood resilience measures to reduce the impact of flooding and allow a faster recovery. Any solution must be cost beneficial to attract public funding.

What formula her Department is using to calculate Special Educational Needs and Disability high needs funding allocations for local authorities next year.

The high needs national funding formula will be used to allocate high needs funding to local authorities in the 2025/26 financial year. Provisional 2025/26 national funding formula allocations for local authorities have now been published and can be found here: https://www.gov.uk/government/publications/national-funding-formula-tables-for-schools-and-high-needs-2025-to-2026.For 2025/26, Surrey County Council has been allocated a provisional high needs funding amount of over £239 million. This represents an increase of 7% per head of their projected 2 to 18-year-old population, compared with their 2024/25 formula allocation.

What the average GP practice patient list is; what the largest patient list was at a GP practice in 2023-4; and what assessment his Department has made of the potential impact of GP list sizes on patient (a) experience and (b) outcomes.

Data on patients registered at a general practice (GP) is published on a monthly basis, and is as follows for 2023/24: at the beginning of 2023/24, 1 April 2023, the largest practice had 106,308 patients, and the median average practice had 8,383 patients; and at the end of 2023/24, 1 April 2024, the largest practice had 98,469 patients, and the median average practice had 8,620 patients.NHS England has overall responsibility for ensuring that there are sufficient primary medical services to meet the reasonable requirements of patients throughout the country. To do so, they will contract providers, such as GPs, to provide these services. GPs are required to provide services to meet the reasonable needs of the patients registered at their practice. This includes making their own workforce plans, and so there is no Government recommendation for how many patients a GP should have assigned.We expect commissioners to act if services are not meeting the reasonable needs of their patients. Under GP Contract regulations, practices can apply to their commissioner to close their patient list to new registrations for a period of time for a number of reasons, including workload and staffing considerations.This data is taken from the Patients Registered at a GP Practice data set, from NHS England Digital. It should be noted that practices can operate across multiple sites or use a digital first approach, which can account for a particularly large patient list. Further information on the data set is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/patients-registered-at-a-gp-practice

What the average per-patient funding for GP practices was in (a) England and (b) NHS Surrey Heartlands in 2023-4.

This data is published annually by NHS England in the NHS Payments to General Practice Report and will be available in due course.

What steps he plans to take to improve the (a) performance of and (b) patient experience at the GP practices in the bottom 5% of the 2024 GP Patient Survey.

We know that general practices (GPs) are working hard to deliver for their patients, and are delivering more appointments than ever before, however we know that some patients are struggling to access the care they need, and GPs are struggling to deliver it.The GP Contract requires NHS England to arrange an annual review of GP contractors’ performance against their contractual obligations. Integrated care boards also consider concerns or complaints raised by patients, and can take action where services are not meeting the needs of their local population.

Whether her Department is taking steps to (a) ensure that deficit reduction measures taken by local authorities as part of their safety valve agreements do not reduce the (i) level and (ii) quality of support for SEND children and young people and (b) monitor such support.

The Safety Valve programme helps local authorities provide an improved special educational needs and disabilities (SEND) service by maximising the impact of their high needs budget and promoting a more stable and effective system for children and young people with SEND. Safety Valve agreements were established only if both the local authority and the department agreed that the proposals would improve services for children and young people with SEND. The future use of Safety Valve agreements is under review.Existing Safety Valve agreements do not in any way release local authorities from their obligation to fulfil their statutory duties to children and young people with SEND, and no agreement would have been made if it compromised a local authority’s ability to meet these obligations. The department regularly reviews the implementation of all Safety Valve agreements through our monitoring process, and provides support and intervention if they go off track. The department does not hold any data on the potential impact of Surrey’s Safety Valve agreement regarding funding per education, health and care plan.

What assessment she has made of the impact of her Department's Safety Valve Agreement with Surrey County Council on (a) funding per EHCP in Surrey and (b) quality of SEND provision in Surrey.

The Safety Valve programme helps local authorities provide an improved special educational needs and disabilities (SEND) service by maximising the impact of their high needs budget and promoting a more stable and effective system for children and young people with SEND. Safety Valve agreements were established only if both the local authority and the department agreed that the proposals would improve services for children and young people with SEND. The future use of Safety Valve agreements is under review.Existing Safety Valve agreements do not in any way release local authorities from their obligation to fulfil their statutory duties to children and young people with SEND, and no agreement would have been made if it compromised a local authority’s ability to meet these obligations. The department regularly reviews the implementation of all Safety Valve agreements through our monitoring process, and provides support and intervention if they go off track. The department does not hold any data on the potential impact of Surrey’s Safety Valve agreement regarding funding per education, health and care plan.

If her Department will take steps to ensure the uplift for SEND funding announced in the Autumn Budget 2024 is allocated by local authorities to families assessed as being in the most urgent need; what steps her Department plans to take to (a) monitor and (b) evaluate the impact of this funding on (i) children and (ii) families in each local authority; and how she plans to report that evaluation.

This government’s ambition is that all children and young people with special educational needs and disabilities (SEND) or in alternative provision receive the right support to succeed in their education and as they move into adult life. The department is providing an increase of almost £1 billion for local authorities’ high needs budgets in the 2025/26 financial year, bringing total high needs funding for children and young people with complex SEND in England to £11.9 billion. The department is now in the process of calculating indicative high needs funding allocations for local authorities next year, which will be published shortly. It is for the local authorities to decide how they manage their spending to secure the best possible outcomes for children and young people within the resources available. Ofsted and the Care Quality Commission jointly inspect local area SEND provision to ensure there is joined-up support for children, young people and their families. These inspections are published and enable the department to intervene in cases of significant concern. The inspections also allow the department to work with local areas and professional advisors to address any areas of weakness that might be identified.

What information her Department holds on the number of education, health and care plan tribunals that were lost by Surrey County Council in each year from 2019 to 2024 to date.

Information about appeals to the First-Tier Tribunal for Special Educational Needs and Disability (SEND) is published at: www.gov.uk/government/collections/tribunals-statistics. The table below sets out the number of appeals to the SEND Tribunal against decisions made by Surrey County Council about education, health and care plans for the period 2020(1) to 2023 (the latest period for which data have been published) which were overturned(2) at Tribunal.YearNumber20201092021277202233120233951 - Data on appeals in 2019 are not available due to HMCTS Record and Retention policy requirements that data is deleted after three years from the conclusion of the appeal and six months if the appeal is withdrawn for SEND Tribunals. The full policy on Record and Retention can be found at: https://assets.publishing.service.gov.uk/media/62b47cfcd3bf7f0af821efef/health-education-social-care-chamber-rrds.pdf.2 - The Tribunal reports a successful appeal if majority of appeals is found in favour of the parent or young person.

Food and Rural Affairs, what recent assessment his Department has made of the effectiveness of flood prevention plans for communities along the River Thames in Surrey between Weybridge and Long Ditton.

The main flood prevention plan currently in development along this part of the River Thames is the proposed River Thames Scheme (RTS). It is a partnership between the Environment Agency (EA), Surrey County Council, and other local partners that will reduce the risk of flooding for communities from Staines to Teddington, including between Weybridge and Long Ditton. This will be achieved through the creation of a new flood channel, in two parts, and capacity improvements to Sunbury, Molesey and Teddington weirs on the Thames and to the river in the Desborough area. The RTS is planning to reduce flood risk to around 11,000 homes and 1,600 businesses. The EA is also looking at how to reduce the impact of flooding in Thames Ditton. Measures under consideration include raised barriers and property flood resilience measures to reduce the impact of flooding and allow a faster recovery.

Food and Rural Affairs, if he will make an assessment of the potential impact of proposed increases to water bills on (a) household disposable income and (b) levels of poverty in Surrey.

It is Ofwat's responsibility, through the price review process, to independently scrutinise company plans and ensure the prices water companies charge customers are fair and proportionate. The Government is committed to taking action to address water poverty and help vulnerable customers with their water bills. All water companies, including Thames Water, have measures in place for customers who struggle to pay for their water and wastewater services, including measures such as WaterSure, social tariffs, payment breaks and holidays, and debt management support. Furthermore, we expect companies to hold themselves accountable for their public commitment to end water poverty by 2030 and will work with the sector to ensure appropriate measures are taken to this end.

Communities and Local Government, if her Department will take steps to (a) improve the transparency of estate charges for freeholders, (b) give freeholders the power to challenge estate charges and (c) give freeholders more powers to take over estate management through a Right to Manage company.

The government is committed to taking steps to bring the injustice of ‘fleecehold’ private estates and unfair maintenance costs to an end and we will consult on the best way to achieve this.In the interim, we will act to provide residential freeholders with greater protections by implementing the relevant provisions of the Leasehold and Freehold Reform Act 2024. The implementation of that Act will require an extensive programme of secondary legislation, and we will set out the details in due course.

Food and Rural Affairs, what steps his Department is taking to reduce sewage discharges into (a) the River Mole and (b) other rivers.

For too long, water companies have discharged record levels of sewage into our rivers, lakes and seas. That is why we are placing water companies under special measures through the Water Bill, which will strengthen regulation, including delivering new powers to ban the payment of bonuses for polluting water bosses and bringing criminal charges against persistent law breakers. We are also carrying out a full review of the water sector to shape further legislation that will transform how our water system works and clean up rivers, lakes and seas for good. With respect to the Mole catchment, the Environment Agency has carried out inspections at six sewage treatment works this financial year. Where permit non-compliance has been found, they have worked with Thames Water to ensure most issues are rectified immediately. Outstanding issues remain under investigation and future action will be considered in line with the Enforcement and Sanctions Policy.

Food and Rural Affairs, if he will make an assessment of the potential impact of increases to Thames Water bills since 2019 on (a) household disposable income and (b) levels of poverty in Surrey.

It is Ofwat's responsibility, through the price review process, to independently scrutinise company plans and ensure the prices water companies charge customers are fair and proportionate. The Government is committed to taking action to address water poverty and help vulnerable customers with their water bills. All water companies, including Thames Water, have measures in place for customers who struggle to pay for their water and wastewater services, including measures such as WaterSure, social tariffs, payment breaks and holidays, and debt management support. Furthermore, we expect companies to hold themselves accountable for their public commitment to end water poverty by 2030 and will work with the sector to ensure appropriate measures are taken to this end.