Written questions by Whittome.

What consideration his Department has given to introducing transitional arrangements for the implementation of UK graduate prioritisation in medical specialty recruitment for the 2025–26 recruitment cycle; and whether he will review the decision to assess applicants’ immigration or settlement status at the point of application rather than at the point of job offer, in cases where applicants will have Indefinite Leave to Remain by the time offers are made.

The Government does not plan to introduce transitional arrangements for the implementation of the Medical Training (Prioritisation) Bill.For 2026 specialty training posts we have used immigration status as a reasonable proxy for National Health Service experience. Subject to parliamentary passage, the bill prioritises applicants at offer stage based on their immigration status at that point. Applicants will be able to update their application status where it has changed since they made their application. For specialty training posts starting from 2027 onwards, the immigration status category will not apply automatically. Instead, we will be able to make regulations to specify any additional groups who will be prioritised by reference to criteria indicating significant experience as a doctor in the health service, or by reference to immigration status. We will set out next steps on these regulations in due course.

What assessment he has made of the adequacy of redundancy arrangements for NHS staff who take partial retirement.

This specific assessment has not been made. Where National Health Service staff have taken partial retirement, they retain continuous service. As a result, some staff may be entitled to receive a statutory redundancy payment that exceeds their contractual redundancy entitlement, in which case, the statutory payment will apply. Entitlement to redundancy payments ultimately depends on what is set out in an employee’s employment contract and whether their contract refers to Section 16 of the Agenda for Change terms. Different rules may apply to NHS staff who are not employed on Agenda for Change terms in England.Contractual redundancy provisions for staff covered by the NHS Terms and Conditions of Service handbook, also referred to as Agenda for Change, were agreed and ratified in partnership by the NHS Staff Council, the collective bargaining structure made up of trade union and employer representatives. Any future changes to the handbook, including this section, would require the Department to issue a mandate to allow negotiations to be undertaken by the NHS Staff Council.

What assessment he has made of the potential impact of long working hours and workforce burnout on staff wellbeing, retention and safe staffing levels within the NHS.

We know from engagement on the 10-Year Health Plan that many National Health Service staff feel disempowered and overwhelmed. Tackling this and providing proper support for staff is a top priority. NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive, including access to high quality health and wellbeing support.The Government is committed to publishing a 10 Year Workforce Plan which will have a focus on supporting and retaining our hardworking and dedicated healthcare professionals. This includes the development of a new set of staff standards for modern employment, which will reaffirm our commitment to improving retention and are likely to focus on flexible working, improving staff health and wellbeing and dealing with violence, racism, and sexual harassment in the NHS workplace. Additionally, we will roll out Staff Treatment Hubs that will ensure staff have access to high quality support for occupational health, including support for mental health and back conditions.

What assessment he has made of the potential merits of a) waiving and b) subsidising the cost of the first six to eight (i) preliminary and (ii) core examinations for junior doctors.

The Department has not made a specific assessment of the potential merits of waiving or subsidising the cost of the first six to eight preliminary and/or core examinations for resident, previously “junior”, doctors.My Rt Hon. Friend, the Secretary of State for Health and Social Care, made two offers to the British Medical Association (BMA) Resident Doctors Committee in 2025 to try to resolve its ongoing industrial disputes. These including provisions to reimburse fees for mandatory royal college examinations to resident doctors in England. However, the BMA rejected these offers.The Government remains determined to put an end to the damaging cycles of disruption caused by strike action and is holding talks with the BMA to resolve the disputes.

What steps he is taking to reduce diagnostic waiting times for gynaecological conditions in Nottingham; and if he will make additional funding available to support gynaecological services.

Reducing diagnostic waiting times, including for gynaecology, is a key part of the Government’s health mission. That is why we are transforming diagnostic services and are taking steps to support the National Health Service to increase diagnostic capacity, including those tests typically used in gynaecology services such as magnetic resonance imaging (MRI) and ultrasound.As set out in the Elective Reform Plan, we plan to build up to five more community diagnostic centres (CDCs), as part of £600 million capital funding for diagnostics in 2025/26. The plan also commits to CDCs opening 12 hours per day, seven days a week, delivering more same-day tests and consultations. In August 2025, we confirmed that 100 CDCs were delivering these extended services.There are already two CDCs located within the NHS Nottingham and Nottinghamshire Integrated Care Board. These are Broad Marsh CDC in Nottingham and Mansfield CDC in Mansfield, which offer patients across Nottingham and Nottinghamshire key diagnostic tests, including MRI and ultrasound.More generally, to support gynaecological services, we are prioritising gynaecology pathways as part of the launch of NHS online. This will give people on certain pathways, such as those with severe menopause symptoms and menstrual problems, the choice of getting specialist case from their home and provide additional capacity to cut waiting times.

What assessment his Department has made of the potential impact of partial retirement for NHS staff on redundancy entitlements; and what discussions his Department has had with NHS representatives on ensuring staff were informed of the employment and redundancy implications of partial retirement.

Partial retirement does not mean that National Health Service staff are ineligible for redundancy payments. However, taking partial retirement may change the way in which contractual redundancy payments are calculated.The rules concerning the calculation of redundancy payments for NHS staff who have previously taken pension benefits, are determined in accordance with their contracts of employment, and statutory redundancy entitlements.Redundancy terms for NHS staff on the Agenda for Change contract are set out under section 16 of the NHS Staff Terms and Conditions of Service handbook. This also applies to NHS staff whose redundancy terms refer to section 16. This section states that service used for the purposes of calculating previous pension benefits will not count for the calculation of a contractual redundancy payment. Statutory redundancy entitlements are unaffected.The Department commissions NHS Employers to provide guidance for employers on a range of topics, including NHS redundancy arrangements and retirement options for NHS staff.

What steps his Department is taking to encourage trainee doctors to take up rehabilitation as a specialism.

We are committed to training the staff we need, including rehabilitation specialists, to ensure patients are cared for by the right professional, when and where they need it.As of September 2025, there are 490 full-time equivalent (FTE) doctors working in the speciality of rehabilitation medicine in National Health Service trusts and other core organisations in England. This is 24, or 5%, more than last year, 116, or 31.2%, more than 2020, and 232, or 90.2%, more than in 2010. This includes over 164 FTE consultants. This is seven, or 4.3%, more than last year, 15, or 10%, more than in 2020, and 50, or 43.8%, more than in 2010. Fill rates for ST3 level rehabilitation medicine have been increasing. 94% of training posts were filled in 2025 compared to 54% in 2023 and 60% in 2024.

What steps his department is taking to increase access to specialist wheelchairs for children in Nottingham East constituency.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, and responsibility for providing disabled children’s equipment would typically fall to the National Health Service and local authorities.NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services. Since July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, with the aim of supporting improvements where required. Further information can be found at the following link:www.england.nhs.uk/statistics/statistical-work-areas/national-wheelchairNHS England is taking steps to reduce regional variation in the quality and provision of NHS wheelchairs, and to support ICBs to reduce delays in people receiving intervention and equipment. This includes publishing a Wheelchair Quality Framework on 9 April 2025 which sets out quality standards and statutory requirements for ICBs, such as offering personal wheelchair budgets. The framework is available at the following link:https://www.england.nhs.uk/long-read/wheelchair-quality-framework/The Nottingham and Nottinghamshire ICB is actively working to ensure equitable access to specialist wheelchair services across the region, including Nottingham City and South Nottinghamshire. This is being pursued through:the procurement of a unified long-term wheelchair service for Mid-Nottinghamshire and Bassetlaw and aligning service specifications and reporting with Nottingham University Hospitals, the provider for South Nottinghamshire and Nottingham City; anda plan to introduce Key Performance Indicators, which will include monthly reporting to monitor access, equipment, and service delivery timescales for children and adults across different localities. This work is planned to start in Nottingham University Hospitals in the third quarter of the 2025/26 financial year.

What steps his Department is taking to reduce waiting times for heart health pathways.

The latest data, from July 2025, shows that 61.6% of waits for cardiology services are within 18 weeks, which is a 1.7% improvement on the same month from the previous year. While this shows progress, we know there is more to do to reduce waiting times for heart health pathways. That is why, along with our commitment to returning to the 92% referral-to-treatment standard for elective care by March 2029, the Elective Reform Plan commits to significant elective reform in cardiology.Cardiology is one of five priority specialties identified for significant elective reform in the Elective Reform Plan. Reforms will include increasing specialist cardiology input earlier in patient care pathways and developing standard and efficient care pathways for common cardiology symptoms. It also includes improving access to cardiac diagnostic tests through implementing more ‘straight-to-test’ pathways, where a general practitioner can refer a patient directly to secondary care for a test. This can reduce unnecessary outpatient appointments and improve waiting times even further for patients across England.These improvements to common cardiology pathways help standardise patient care, reduce inequalities, and improve access to care, especially in the early stages of heart health pathways for patients across England.

What steps he is taking to ensure the safe disposal of needles in the context of the growing use of GLP-1 medicines; whether his Department has had discussions with pharmaceutical companies about meeting the costs of this disposal.

It is important for sharps to be disposed of safely, to avoid risk of accidental needle-stick injuries to pharmacy or general practice staff, waste management operatives, and other members of the public. All sharps should be disposed in sharps bins, which can be obtained on prescription or purchased. Local authorities are obliged to collect clinical waste, including sharps bins, from householders upon request. Under section 45(3)(b) of the Environmental Protection Act 1990 they may make a reasonable charge for this service.The Department has had no discussions with the pharmaceutical industry about meeting the cost of this disposal.

What steps his Department is taking to ensure adequate mental health support is provided to Physician Associates following the publication of the Leng Review.

The health and wellbeing of all National Health Service staff is hugely important. Following the publication of the Leng Review, NHS England has written to NHS trusts, integrated care boards, and primary care networks reiterating their responsibilities to their staff as employers, including treating them with compassion and providing pastoral support where required. Importantly, it has also written directly to the staff most affected by the recommendations, setting out where they can find support if required. Employers across the NHS have their own arrangements in place in line with their duty of care for supporting their staff, including occupational health provision, employee support programmes, and board level scrutiny through health and wellbeing guardians.

What steps he is taking to (a) improve awareness and understanding of Progressive Supranuclear Palsy among healthcare professionals across all regions of England, and (b) ensure earlier and more accurate diagnosis of the condition.

Under the UK Rare Diseases Framework, the Government is committed to improving the lives of those living with rare diseases, such as progressive supranuclear palsy. This includes helping patients get a final diagnosis faster and increasing awareness of rare diseases among healthcare professionals.With over 7,000 rare diseases, it is not possible for healthcare professionals to receive comprehensive training on every condition. It is therefore important that they are aware of rare diseases more broadly and are alert to considering them. The 2025 England Rare Diseases Action Plan updates on progress to increase awareness of rare diseases among healthcare professionals, including:- Launching new resources on the innovative digital educational resource, GeNotes;- Developing a communication skills resource to aid healthcare professionals in having sensitive conversations to ensure the patient feels supported in their diagnosis of a rare condition; and- Developing a range of training and educational resources on rare diseases to include rare diseases in UK health professional education and training frameworks.Another priority of the Framework is to help patients get a final diagnosis faster. Progress has been made over the last year, including research commissioned to better understand what causes delays in diagnosis, the Generation Study to pilot whole genome sequencing of newborns in the NHS being launched, and the work of the NHS Genomic Medicine Service.

What assessment he has made of the potential merits of providing free homecare.

Local authorities (LAs) have the power to charge for care, and it is for them to decide whether to do so. Two LAs in England currently offer free home care to their residents.Where LAs do choose to charge for care, they must do so in accordance with the Care Act 2014 and the Care and Support (Charging and Assessment of Resources) Regulations 2014, and they must act under the Care and Support Statutory guidance.We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service.The commission, which began work in April 2025, will be comprehensive and will build on the expert proposals of other reviews, including that of Sir Andrew Dilnot into care funding and support. It will be broader and wider than ever before, asking essential questions about the shape and future of the social care sector, including what long-term and sustainable funding solutions should look like.

What assessment he has made of the merits of continuing opt-out testing of Hepatitis (a) B and (b) C in Nottingham University Hospitals’ Emergency Department.

The emergency department opt-out testing programme will continue to test individuals for bloodborne viruses, including HIV and viral hepatitis, in line with committed funding plans. The Government is committed to reducing the incidence of viral hepatitis, including by reducing the number of people living with the condition without a diagnosis. NHS England is currently reviewing its budgetary position, with a view to determining whether funding can be made available to extend the provision of opt out testing for viral hepatitis, particularly for those sites whose committed funding will end during 2025. This includes the Nottingham University Hospitals NHS Trust, and therefore NHS England is engaged in discussions with the trust on this important programme.

What progress his Department has made in implementing the NHS Accessible Information Standard.

Since 2016, all National Health Service 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 self-assessment framework has been developed to support providers of NHS and social care services to measure their performance against the AIS, and to develop improvement action plans to address gaps in implementation.A revised AIS will be published in due course. In the meantime, the current AIS remains in force, and therefore there should be no gap in provision for people using services. NHS England is working to support implementation of the AIS with awareness raising, communication, and engagement, and with a review of the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.

With reference to the Written Statement of 5 December 2024 on Plan for Change: Milestones for mission-led government, HCWS285 and the Chapter on An NHs Fit for the Future, if he will publish plans to reduce waiting times for mental health services.

Our 10-Year Health Plan will inform the future vision and delivery plan for mental health services in England. Earlier intervention remains a key focus of the plan, with the aim of reducing pressure on mental health services.The Government is delivering new and innovative models of care in the community. We have launched six neighbourhood adult mental health centres that are open 24 hours a day, seven days a week, to bring together community, crisis, and inpatient care.NHS England’s Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity.We are also improving data quality so we can support providers in understanding demand across their areas. Since July 2023, NHS England has included waiting time metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication, to help services target the longest waits.

What steps he is taking to ensure that people living in Nottingham East constituency have access to NHS dentistry when they need it.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Nottingham East constituency, this is the NHS Nottingham and Nottinghamshire ICB. ICBs have been asked to start making extra urgent dental appointments available from April 2025. The Nottingham and Nottinghamshire ICB is expected to deliver 24,360 additional urgent dental appointments as part of the scheme.ICBs have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. As of 10 April 2025, in England, there are 53 dentists in post with a further 44 dentists who have been recruited but are yet to start in post. Another 256 posts are currently advertised.

What steps he is taking to ensure that patients referred for a potential diagnosis of Parkinson’s disease are seen by a neurologist within 18 weeks.

The Government is committed to delivering the National Health Service constitutional standard for 92% of patients to wait no longer than 18 weeks from Referral to Treatment by March 2029, a standard which has not been met consistently since September 2015. This includes patients waiting for elective treatment on neurological pathways.We have taken our first step towards delivering this commitment goal by exceeding our pledge to deliver an extra two million operations, scans, and appointments in our first year in office, having now delivered over three million more appointments.The Elective Reform Plan, published in January 2025, sets out the specific productivity and reform efforts needed to return to the constitutional standard.The Getting It Right First Time programme, which provides tailored regional and national support to providers, also has a neurology specific Further Faster workstream. This is a clinically led initiative supporting peer to peer learning and improvement. A neurology 'handbook' and checklist with benchmarked data and case studies has been published and there are regular neurology online sessions for clinical and operational leads.

What steps his Department is taking to ensure that people diagnosed with Parkinson’s disease have access to (a) appropriate information, (b) treatment options and (c) a multidisciplinary care team.

There are 27 specialised neurological treatment centres across the National Health Service in England, which provide access to neurological multidisciplinary teams to ensure that patients with Parkinson’s disease can receive specialised treatment and support, according to their needs.Most services for long-term conditions are commissioned locally by integrated care boards (ICBs), including for Parkinson’s. It is the responsibility of ICBs, working with clinicians, service users, and patient groups, to develop local services and care pathways that are convenient and that meet patients’ needs.The National Institute for Health and Care Excellence (NICE) publishes guidance on the diagnosis and treatment of long-term conditions for use by healthcare professionals and commissioners. The NICE published Parkinson’s disease in adults guidance in July 2017, which is available at the following link:https://www.nice.org.uk/guidance/ng71/chapter/recommendationsThe NICE guidance includes that communication with people with Parkinson's disease should aim towards empowering them to participate in judgements and choices about their own care, and individually tailored and consistent communication from the professionals involved.We have launched a 10-Year Health Plan to reform the NHS and improve care for people with long-term conditions, such as Parkinson’s disease. A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to make it more accessible, proactive, and tailored for patients.

What steps his Department is taking to increase the (a) recruitment of nurses and (b) availability of jobs for newly qualified nurses.

Decisions about the employment of newly qualified nurses are a matter for individual National Health Service trusts. NHS trusts manage their recruitment at a local level ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.We will publish a refreshed Long Term Workforce Plan to ensure the NHS has the right people, in the right places, with the right skills to deliver the care patients need.