Written questions by Hudson.

How the Modern Service Framework for Frailty and Dementia will reflect the complexity of dementia within system design, including coordination across health and social care services.

We want those living with dementia to benefit from better joined up care and coordination across services, and continue to engage with key professional groups, including those working within health and social care and neighbourhood health, while developing the modern service framework to support greater national coordination.The Frailty and Dementia Modern Service Framework Task and Finish Group is an advisory body to offer insight and guidance, helping to shape the Modern Service Framework for Frailty and Dementia by drawing on expertise from across the health and care system. The first meeting took place on 25 March and these meetings will occur monthly.To ensure we account for considerations across the health and social care sector, the Frailty and Dementia Modern Service Framework is co-chaired by:Dr Jeremy Isaacs, Consultant Neurologist at St George’s and Kingston Hospitals and National Clinical Director for Dementia and Older People’s Mental Health at NHS England;Sarah McClinton, Chief Social Worker for Adults and Mental Health Social Work lead in the Department of Health and Social Care; andProfessor Jugdeep Dhesi, Consultant Geriatrician at Guy’s and St Thomas’ NHS Foundation Trust, Professor of Geriatric Medicine at Kings College London and President of the British Geriatrics Society.

What steps his department is taking to ensure that Advance Care Planning for people with dementia is a) proactive, b) effective and c) regularly reviewed.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services.Those with dementia will benefit from more joined up care through co-created care plans, and by 2027, 95% of those with complex needs will have an agreed care plan.We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, which is expected this year.In developing the Modern Service Framework for Frailty and Dementia, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with frailty and dementia.

What steps he is taking to ensure that the Modern Service Framework for Frailty and Dementia includes a clear, defined pathway for post-diagnostic support for people with dementia.

In developing the Modern Service Framework (MSF) for Frailty and Dementia, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with frailty and dementia.We will consider what interventions should be supported to improve care and support for those living with dementia. We are considering all options to help reduce variation, including reviewing metrics and targets.We will also review existing guidance and literature, including the Dementia 100 pathway assessment tool, which continues the work of the Dementia Care Pathway and covers all elements of the Well Pathway.We are working to develop the content of the framework as soon as possible and we will keep partners updated on progress and timings as this work unfolds. We are committed to publishing an interim product in September this year to feed into National Health Service and local government planning cycles, and will aim to publish the full MSF by the end of this calendar year.

What assessment his Department has made of (a) the prevalence of respiratory disease and (b) the number of emergency hospital admissions for respiratory conditions in Epping Forest; and what steps he is taking to ensure respiratory health is prioritised nationally, including through the introduction of a Modern Service Framework for respiratory care.

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is the potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.Available data on trends in respiratory conditions can be found on the Department’s fingertips dataset. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority, and integrated care board level. Information for Essex can be found at the following link: https://fingertips.phe.org.uk/search/Respiratory#page/1/gid/1/pat/15/ati/502/are/E10000012/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

What steps he is taking to improve access to routine tissue freezing for brain cancer patients in a) Epping Forest and b) England for even access to advanced treatments, diagnostics and research.

Fresh-freezing, also referred to as snap-freezing, is a standard technique used by pathology networks to preserve tissue architecture without chemical fixatives, allowing for subsequent molecular or histological analysis, typically supporting research or advanced diagnostic applications.No recent assessment has been made on the adequacy, extent, or capacity of procedures for freezing brain cancer and general cancer tissue samples across National Health Service trusts in Epping Forest or England.It is important that everyone, regardless of where they live, can access the latest innovations in the health and care system through research. The Department invests over £1.6 billion each year in research through the National Institute of Health and Care Research (NIHR). The NIHR’s investments for capital equipment, technology, and modular buildings support NHS trusts across England to deliver high-quality research to improve the health of the population. This investment includes cutting edge research equipment and fixed assets such as ultra-low and cryogenic freezers, to strengthen research capacity and improve access to samples for research.The Department is exploring options to expand brain tissue freezing capacity.

With reference to his Department's press release entitled Boost to mental health services from thousands of extra staff, published on 27 June 2025, how the recruitment of 6,700 mental health staff in the most recent year compares with the number recruited in each of the previous five years.

NHS England publishes monthly data on the National Health Service Hospital and Community Health Service (HCHS) workforce in England. This includes data on the NHS mental health workforce employed by NHS provider trusts and integrated care boards.Within the NHS Monthly Workforce Statistics series, data on the mental health workforce is included in the file titled “Preliminary – NHS HCHS Workforce Statistics, Trusts and core organisations – data tables, September 2025”. The file is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/august-2025Tab 21 within the file contains information on the mental health workforce broken down by staff groups, NHS England region, and care setting or specialty, including a monthly time series from January 2024 onwards and earlier annual figures for each September.Further data on the mental health workforce is included in the file titled “HCHS Mental Health Workforce in NHS Trusts and core orgs June 2025”. The file is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/june-2025This file provides quarterly FTE data from 30 September 2009 to 30 June 2025.

What steps he is taking to help ensure that hospice contracts adequately reflect the (a) cost of the services they provide and (b) needs of their local populations.

Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. NHS England has developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population.Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on the demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations. The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan. Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local ICBs and on behalf of NHS England, as happened in 2024/25 and 2025/26.  This amounts to approximately £80 million over the next three years.

What steps he is taking to help ensure adequate levels of accountability for the equitable provision of palliative care across England.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.We will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.Additionally, through the National Institute for Health and Care Research, the Department is investing £3 million in a new Policy Research Unit in Palliative and End of Life Care. This unit launched in January 2024 and is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.On ICB accountability, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that charitable hospices play as well, which is why we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local ICBs and on behalf of NHS England, as happened in 2024/25 and 2025/26. This amounts to approximately £80 million over the next three years.

Whether he has considered fully funding the (a) specialist palliative care, (b) advice and (c) assessments that are provided by hospices.

Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life, as well as their loved ones. Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area. It is important to note that hospices, like the NHS, provide both specialist and generalist palliative care and end of life care. Not all patients will require specialist palliative care. We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local ICBs and on behalf of NHS England, as happened in 2024/25 and 2025/26.  This amounts to approximately £80 million over the next three years.

What steps his Department is taking to help ensure that hospices receive the funding required to raise staff pay in line with nationally agreed NHS pay rises.

We are immensely grateful for the critical role healthcare workers, including hospice staff, play in our health service and the high quality, compassionate care they deliver.The impact that National Health Service pay uplifts will have on the hospice sector will depend on the structure of the charity, which includes the number of employees and the salary levels. Independent organisations, such as charities and social enterprises, are free to develop and adapt their own terms and conditions of employment, including the pay scales.It is for them to determine what is affordable within the financial model they operate, and how to recoup any additional costs they face if they choose to utilise the terms and conditions of NHS staff on the Agenda for Change contract.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local integrated care boards and on behalf of NHS England, as happened in 2024/25 and 2025/26.  This amounts to approximately £80 million over the next three years.

Whether his Department has made an assessment of the potential impact of the increase in Food Security Agency charges for the 2025/26 financial year on small and medium-sized abattoirs.

The Food Standards Agency (FSA) conducts and charges for official controls, inspections, in abattoirs, which help to ensure that food hygiene and animal welfare standards are met. The controls are an intrinsic component in our food system which provide reassurance for the wider food industry and consumers, as well as trading partners to facilitate meat exports. Information on the 2025/26 charge rates is available on the FSA’s website at the following link: https://www.food.gov.uk/business-guidance/charges-for-controls-in-meat-premises As in previous years, the impact of charges is offset by a taxpayer-funded discount which provides the greatest proportional support to smaller businesses. The impact of the support on different sized food businesses in England and Wales for 2025/26 is set out in the Cost Data Slides which the FSA has published at the following link: https://www.food.gov.uk/sites/default/files/media/document/Meat%20hygiene%20cost%20data%202025-2026%20_1.pdf The FSA is currently conducting an evaluation of the support provided via the discount and will assess the impact of any changes it might propose in the light of this evaluation.

If his Department will take steps to ensure all Integrated Care Boards have Fracture Liaison Services.

Fracture Liaison Services are commissioned by integrated care boards, which are well-placed to make decisions according to local need. Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.

What information his Department holds on when the rebuilding of (a) Whipps Cross Hospital and (b) Princess Alexandra Hospital will be completed.

As set out in the New Hospital Programme Plan for Implementation, the new hospital schemes for Whipps Cross Hospital and Princess Alexandra Hospital are in Wave 2 and are expected to commence construction between 2032 and 2034. Completion dates for all schemes will be confirmed following the approval of a Full Business Case, as set out in HM Treasury Green Book and as is usual for large infrastructure projects. Further information on the New Hospital Programme Plan for Implementation is available at the following link:https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-plan-for-implementation

If he will make an assessment of the potential impact of penalties for the illegal sale of vaping products on those sales.

Trading Standards officers currently have a range of enforcement tools at their disposal to enforce age of sale restrictions and to take a proportionate approach to enforcement that reflects the severity of the offence committed. When necessary, this includes prosecuting offenders, which can result in a court imposed fine of up to £2,500, and, in the case of repeat offences, an application for a restricted premises order or restricted sale order. £200 fixed penalty notices, introduced by the Tobacco and Vapes Bill, will complement existing sanctions and support Trading Standards to crack down on retailers selling to underage people.We will complete a post-implementation review of the measures in the Tobacco and Vapes Bill in due course.The sale and supply of single use vapes was banned on 1 June 2025. If a retailer repeatedly sells single use vapes, they can be charged with an unlimited fine, or a prison sentence of up to two years. We will work with enforcement agencies to monitor the impact and effectiveness of the ban, including the impact of the penalties.

What steps he is taking to help tackle the sale of illegal nicotine pouches.

In Great Britain, nicotine pouches are currently regulated under the General Product Safety Regulations 2005, meaning they are subject to general product safety requirements enforced by Trading Standards, including labelling with safety information and instructions for use.The Tobacco and Vapes Bill will enhance the regulation of nicotine pouches by providing powers to restrict product packaging and flavours. Powers in the bill will also allow the Government to limit the amount of nicotine in a pouch, as well as ban any other ingredient that might be harmful.The Government is taking a range of action to tackle illegal nicotine pouches and protect young people from potential harms. The bill will strengthen enforcement and crack down on rogue retailers by enabling the introduction of a retail licensing scheme in England, Wales, and Northern Ireland. The bill also provides powers to develop a new registration system for all tobacco, vape, and nicotine products. This will help Trading Standards to enforce our rules on product requirements and support improving consumer safety.Alongside the bill, the Government has announced £10 million of new funding in 2025/26 to Trading Standards, to tackle illicit and underage sales, and to support the implementation of the measures in the bill. This funding will be used to boost the Trading Standards workforce by recruiting approximately 80 new apprentices.

If the will increase funding for mental health services in rural areas.

Mental health is and will remain a priority for the National Health Service across the country, including for those in rural areas. This is backed by the Mental Health Investment Standard, which in 2025/26 will continue to ensure that mental health funding is ring-fenced to support the delivery of our commitments, including those outlined in NHS Planning Guidance.

What steps his Department is taking to help improve capacity in dementia diagnostics to facilitate access to new dementia treatments.

The Government is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres (CDCs), and better use of technology. With 170 CDCs due to be up and running by the end of March 2025, CDCs can take on more of the growing diagnostic demand within elective care. We will also deliver additional CDC capacity in 2025/26 by expanding several existing CDCs and building up to five new ones.To prepare for the new generation of dementia treatments in development, NHS England is working closely with regulators to ensure that arrangements are in place to support the adoption of any new licensed and treatments recommended by the National Institute for Health and Care Excellence as soon as possible.Alongside Alzheimer’s Research UK, Alzheimer’s Society, Gates Ventures and the People’s Postcode Lottery, the National Institute for Health Research is funding the Blood Biomarker Challenge which seeks to produce the clinical and economic data that could make the case for the use of a blood test in the NHS to support diagnosis of dementia.

How his Department plans to (a) increase the number of scanners available for dementia diagnosis and (b) reduce diagnosis times for patients.

The Government is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres (CDCs), and better use of technology.With 170 CDCs due to be up and running by the end of March 2025, CDCs can take on more of the growing diagnostic demand within elective care. We will also deliver additional CDC capacity in 2025/26 by expanding a number of existing CDCs and building up to five new ones.Alongside Alzheimer’s Research UK, Alzheimer’s Society, Gates Ventures and the People’s Postcode Lottery, the National Institute for Health Research is funding the Blood Biomarker Challenge which seeks to produce the clinical and economic data that could make the case for the use of a blood test in the NHS to support diagnosis of dementia.

What assessment he has made of the effectiveness of the NICE process on the wider societal cost of dementia when appraising new dementia treatments.

The National Institute of Health and Care Excellence (NICE) develops its guidance independently and based on an assessment of the available evidence. In developing its recommendations, NICE considers all health-related costs and benefits for patients and caregivers, in line with its established methods and processes. NICE does not consider wider societal costs and benefits.Any changes to NICE methods to broaden its cost-benefit analysis and incorporate wider societal costs would be both methodologically and ethically challenging. Such changes could have unintended consequences, potentially leading to fewer treatments being recommended for populations that are older, economically inactive, or have greater care needs.

What steps he plans to take to support the (a) development and (b) use of eye scans for diagnosing dementia.

The Government is committed to transforming diagnostic services, including the detection and diagnosis of dementia, and will support the National Health Service to increase capacity to meet the demand for diagnostic services.The Government’s Dame Barbara Windsor Dementia Goals programme is investing in biomarker innovations ranging from an artificial intelligence tool designed to improve the accuracy of blood tests for dementia, to using retinal scans to detect early-onset dementia decades before symptoms. Some of these innovations could support improved diagnosis in the future, if validated for clinical use.The Department delivers dementia research via the National Institute for Health and Care Research (NIHR). The NIHR funds a range of research into diagnosing dementia, including investing nearly £11 million of funding to develop new digital approaches for the early detection and diagnosis of dementia.As part of the NIHR funded DaRe2THINK sub-study, researchers are using tests, including eye scans, to look at the effects of blood thinning medications on preserving brain function and assessing the real-time disease burden of dementia.