Written questions by Shastri-Hurst.

In what month this year he expects the Urgent and Emergency Care Improvement Plan to be published.

The urgent and emergency care improvement plan will set expectations for the National Health Service in England to deliver improvements in urgent and emergency care services and set the foundations for future areas of reform, in line with the 2025/26 NHS Operational Planning Guidance. It is anticipated that the plan will be published as part of the current NHS planning round.

With reference to section 1 of the Down Syndrome Act 2022, when his Department plans to publish the guidance.

Officials have been working to develop the Down Syndrome Act 2022 statutory guidance, including engaging with sector partners and the relevant departments.We expect to issue the draft guidance of the public consultation by the summer of 2025. The guidance will be published at the earliest opportunity following the consultation.

What assessment he has made of the potential impact of delays in accessing givinostat through the Early Access Programme on boys and young men living with Duchenne muscular dystrophy in the UK.

The Department understands the impact that Duchenne muscular dystrophy has on those living with it and their families, and the urgent need for new treatment options. The National Institute for Health and Care Excellence (NICE) recently published guidance that recommends the medicine vamorolone for treating Duchenne muscular dystrophy in people 4 years old and over. The National Health Service is required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.The Department has not had any discussions with ITF Pharma UK about resources or guidance available to NHS trusts participating in the early access programme for givinostat. Departmental officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as early access programmes, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What discussions his Department has had with (a) NHS England and (b) ITF Pharma UK to ensure that NHS Trusts have the necessary resources and guidance to take part in the Early Access Programme for givinostat.

The Department understands the impact that Duchenne muscular dystrophy has on those living with it and their families, and the urgent need for new treatment options. The National Institute for Health and Care Excellence (NICE) recently published guidance that recommends the medicine vamorolone for treating Duchenne muscular dystrophy in people 4 years old and over. The National Health Service is required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.The Department has not had any discussions with ITF Pharma UK about resources or guidance available to NHS trusts participating in the early access programme for givinostat. Departmental officials have had discussions with colleagues in NHS England about the guidance and resources that are available to NHS trusts. NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as early access programmes, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What his timetable is for implementing fixed recoverable costs to clinical negligence claims.

Currently, the Government is considering the way forward on a wide range of matters, including clinical negligence costs reform, and we will announce our position in due course.

Pursuant to he Answer of 27 January 2025 to question 24346 on NHS: Standards, how many additional Value Weighted Activity appointments have been delivered since 5 July 2024.

Between July 2024 and November 2024, the latest available data, there were 1,635,136 more value-weighted activity appointments compared to the period July 2023 to November 2023.This includes elective ordinary and day case admissions, outpatient first appointments, and outpatient follow-up appointments with a procedure. It does not include other outpatient follow-ups, or diagnostic tests, except for endoscopy tests which are included within elective admissions or outpatient procedures as appropriate.Including diagnostic tests, between July 2024 and November 2024, the latest available data, there were 2,199,579 more appointments compared to the period July 2023 to November 2023.

On how many occasions he has met representatives of each medical Royal College since 5 July 2024.

Meetings with external organisations are routinely disclosed in the Department’s transparency publications. Two returns have been published since 5 July 2024, one in September, and one in December. Further information is available at the following link:https://www.gov.uk/government/collections/ministerial-gifts-hospitality-overseas-travel-and-meetings#2024

Which appointments will count towards the plan to deliver 40,000 more NHS appointments a week.

Tackling waiting lists is a key part of our Health Mission, and we will deliver an additional 2 million operations, scans, and appointments during our first year in Government, which is equivalent to 40,000 per week, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks.Appointments will be defined as those in scope of the Value Weighted Activity metric, which is used to measure elective activity as set out in NHS Operational Planning guidance, together with the key diagnostic times from diagnostic waiting times statistics. Value Weighted Activity includes elective ordinary admissions and day cases, outpatient first appointments, and outpatient follow-up appointments with a procedure. This excludes outpatient appointments without procedure, to ensure that the appointments we are counting are high value for patients. Elective admissions for endoscopies are also excluded to avoid the double counting of diagnostics.Further information about the delivery of the additional appointments will be published at the earliest opportunity.

How he is measuring the delivery of 40,000 more NHS appointments a week.

Tackling waiting lists is a key part of our Health Mission, and we will deliver an additional two million operations, scans, and appointments during our first year in Government, which is equivalent to 40,000 per week, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks.The Department regularly monitors the number of appointments the National Health Service is delivering using internal management information. Official measurement of the additional appointments will be published at the earliest opportunity.

What assessment he has made of the potential impact of increases in employers' National Insurance contributions on the (a) retention and (b) recruitment of salaried GPs.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. The employers’ National Insurance rise will be implemented in April 2025. We will set out further details on the allocation of funding for next year in due course.Primary care providers, including general practitioners (GPs), are valued independent contractors that provide nearly £20 billion worth of National Health Services. Every year we consult with each contracted sector about the services it provides, and the money providers are entitled to in return. As in previous years, this issue will be dealt with as part of that process. We will shortly begin discussions on the annual GP Contract.

What assessment he has made of the potential impact of of climate change on instances of malaria in the United Kingdom.

Malaria is not currently transmitted in the United Kingdom, but travel-associated cases occur in those who have returned to, or arrived in, the UK from malaria-endemic areas. Modelling has investigated the impact of different climate change scenarios on the likelihood for plasmodium falciparum transmission in the UK. Four of the five models suggested a low risk by the year 2100, even at extreme scenarios, with the fifth model predicting suitability in southern England for sustained transmission lasting more than one month by 2080. With climate change, theoretically a warmer summer would reduce the extrinsic incubation of the pathogen in mosquitos and increase the local malaria risk.

What assessment he has made of the potential impact of proposed changes to National Insurance contributions on the retention and recruitment of non-clinical staff in GP surgeries.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. The employers’ National Insurance rise will be implemented in April 2025. We will set out further details on the allocation of funding for next year in due course.Primary care providers, including general practitioners (GPs), are valued independent contractors that provide nearly £20 billion worth of National Health Services. Every year we consult with each contracted sector about the services it provides, and the money providers are entitled to in return. As in previous years, this issue will be dealt with as part of that process. We will shortly begin discussions on the annual GP Contract.

What steps he has taken to improve the study of tropical diseases in medical school curricula.

It is the responsibility of individual UK medical schools to determine the content of their own curricula. The delivery of these undergraduate curricula has to meet the standards set by the medical regulator, the General Medical Council (GMC), who monitors and checks to make sure that these standards are maintained. GMC standards require the curriculum to be formed in a way that allows all medical students to meet the GMC’s Outcomes for Graduates by the time they complete their medical degree, which describes the knowledge, skills and behaviour they have to show as newly registered doctors.

What assessment he has made of the potential impact of increases in employers National Insurance contributions on the (a) provision and (b) resilience of air ambulance services.

No such assessment has been made. The Government has protected the smallest businesses and charities from the impact of the increase to employer National Insurance, by increasing the Employment Allowance from £5,000 to £10,500, which means that 865,000 employers will pay no National Insurance contributions (NICs) at all next year, more than half of employers will see no change or will gain overall from this package, and all eligible employers will be able to employ up to four full-time workers on the National Living Wage and pay no employer NICs.

What assessment he has made of the potential impact of increases to employers National Insurance contributions on the (a) retention and (b) recruitment of nurses in GP surgeries.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. The employers’ National Insurance rise will be implemented in April 2025. We will set out further details on the allocation of funding for next year in due course.Primary care providers, including general practitioners (GPs), are valued independent contractors that provide nearly £20 billion worth of National Health Services. Every year we consult with each contracted sector about the services it provides, and the money providers are entitled to in return. As in previous years, this issue will be dealt with as part of that process. We will shortly begin discussions on the annual GP Contract.

What steps his Department is taking to help community pharmacies with (a) funding, (b) workforce and (c) supply of medicines.

The Government is committed to expanding the pharmacy workforce and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists, as we shift care from the hospital to the community.We have inherited ongoing global supply problems that continue to impact medicine availability. We know how frustrating this can be for patients and community pharmacists. We are working closely with industry, the National Health Service, manufacturers, and other partners in the supply chain to resolve issues as quickly as possible to make sure patients can access the medicines they need.Now that the budget for the Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements for 2024/25. We are unable to say more until these have been concluded.

With reference to the findings of Lord Darzi's Independent investigation of the NHS in England, published on 12 September 2024, what steps his Department is taking to support community pharmacies with (a) funding, (b) workforce and (c) medicine supply challenges.

We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. From 2026, all newly qualified pharmacists will be independent prescribers, and we are investing in training legacy staff to develop clinical and technical roles.The consultation with Community Pharmacy England on the national funding and contractual framework arrangements has not yet been concluded, and we are looking into this as a matter of urgency.We have inherited ongoing global supply problems that continue to impact medicine availability. We know how frustrating this can be for patients and community pharmacists. We are working closely with industry, the National Health Service, manufacturers, and other partners in the supply chain to resolve issues as quickly as possible to make sure patients can access the medicines they need.

What assessment his Department has made of the adequacy of the processes for supporting patients presenting to General Practitioners with mental health disorders attributable to gambling.

We are committed to supporting improvements to the existing treatment system, ensuring people experiencing gambling-related harm are able to access the right care at the right time.NHS England now operates 15 specialist gambling treatment clinics, up from two in 2019, with representation across every region in England. Through these clinics, the National Health Service has capacity to treat up to 3,000 people experiencing gambling-related harms each year.General practitioners are responsible for ensuring their own clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence (NICE), to ensure that they can continue to provide high quality care to all patients.The NICE is currently developing a gambling-related harms guideline, focused on identification, assessment, and management of people who may be harmed by gambling. Publication is expected later this year.

How many veterans are receiving specialist mental health support.

Veterans can access specialist mental health support either through Op COURAGE, a bespoke integrated mental health pathway for veterans, or NHS Talking Therapies. As of 30 June 2024, Op COURAGE reported that they were actively supporting 2,702 veterans. Since its inception in April 2017, there have been over 38,500 referrals to Op COURAGE. In addition to the Op COURAGE services, between 1 April 2020 and 30 June 2024, 63,810 veterans have entered NHS Talking Therapy treatment services.