Written questions by Glover.

How his Department’s 10 Year Health Plan will support patients with multiple sclerosis in receiving adequate (a) care and (b) support.

The three shifts outlined in the 10-Year Health Plan will support people with long-term conditions, including those with multiple sclerosis, to better manage their condition and access services closer to home. For example, it will empower them to access their medical history and allow them to book and manage their appointments and medication.In addition, by 2028/29, neighbourhood health teams will be organised around the needs of their patients. The plan will create joined-up working across hospitals and into community settings, with multi-disciplinary teams who can provide wrap-around support services.By 2030, one million patients with long-term conditions will be offered personal health budgets, which will enable them to use National Health Service resources and to determine the care that best suits their needs.Patients will be able to self-refer to services where clinically appropriate through My Specialist on the NHS App. This will accelerate their access to treatment and support. The NHS App will provide access to advice, guidance, self-care support, and appointment management. Patients will be able to manage their care in one place, giving them direct access to, and preference over the services they need.As part of the NHS App, My Medicines will enable patients to manage their prescriptions, and My Health will enable patients to monitor their symptoms and bring all their data into one place.

What assessment his Department has made of the potential impact of the NHS England Getting It Right First Time neurology programme on the (a) quality and (b) consistency of multiple sclerosis care.

The Getting it Right First Time (GIRFT) National Specialty Report made recommendations designed to improve neurology services nationally and to support the National Health Service to deliver care more equitably across the country. The National Specialty Report highlighted differences in how services are delivered and offered an unprecedented opportunity to share successful initiatives between trusts to improve patient services nationally. Building on the GIRFT National Specialty Report, the Neurology Transformation Programme has developed a model of integrated care for neurology services to support integrated care boards to deliver the right service, at the right time for all neurology patients, including those with multiple sclerosis (MS). This focuses on providing access equitably across the country, care as close to home as possible, and early intervention to prevent illness and deterioration in patients with long-term neurological conditions. The Neurology Transformation Programme has developed a national data dashboard for integrated care systems to monitor delivery of MS care, including for disease-modifying therapies. Additionally, NHS England has also developed guidance for systems on improving access to disease-modifying treatments for MS closer to home, which includes successful delivery models and good practice case studies.The Neurology Transformation Programme is working with the National Clinical Director for Neurology and the Neurology Clinical Reference Group to develop a revised service specification for neurology. The updated service specification will further build on the specific recommendations in the GIRFT report and will include specific guidance for pathways for MS and other neuroinflammatory conditions.

Whether he plans to consult health professionals as part of the changes to the Carr-Hill formula funding model for GP practices.

The review of the Carr-Hill formula will draw on a range of evidence and advice from experts, such as the Advisory Committee on Resource Allocation, and will involve consultation with the General Practitioners Committee of the British Medical Association. Further detail on the review will be confirmed in due course.

What steps (a) his Department and (b) NHS Blood and Transplant are taking to increase the number of blood donations.

NHS Blood and Transplant (NHSBT) is responsible for blood services in England. NHSBT has been using several initiatives to increase blood donations and in turn improve blood stocks.For instance, the Department provided seed-funding to support NHSBT’s work to increase collection capacity and resilience, including the new Brixton Donor Centre which opened in December 2024. Additionally, the newly re-opened donor centre in Southampton and the Brighton donor centre that will open later in the year will increase NHSBT’s capacity to collect more blood.National Blood Week, between 9 and 13 June 2025, saw campaigns seeking to recruit donors, particularly for blood groups where demand is high, and to increase the number of bookings. Messaging included a strong call to action for a million people to become regular donors.NHSBT has a hotline to enable priority donors, which are currently O negative, B negative, and Ro donors, to find an available appointment. This function will be available for online and app bookings later in June 2025.A Marketing Automation Tool was launched in September 2024 that will enable NHSBT to personalise the messages it sends to donors so that over the coming year, more of the communication donors receive will be relevant to them, making it easier for them to book an appointment at a time and place that suits them.

Whether he has considered launching a time-limited regional pilot of a blood-donor loyalty programme that awards perks to donors.

NHS Blood and Transplant (NHSBT) is responsible for blood services in England. NHSBT has a Donor Recognition Scheme (DRS) that thanks donors, using personalised emails at various milestones, digital badges, and for higher donation thresholds, distributes pin badges and formal certificates. Further information on the DRS is available at the following link:https://www.blood.co.uk/the-donation-process/recognising-donors/NHSBT’s strategic objective is to grow and diversify the donor base to meet evolving hospital needs, and to reduce health inequalities. To support this, the DRS is being reviewed. The new approach will shift the emphasis from recognition alone to retention, with a stronger focus on engaging newer donors. In the coming year, a series of pilots will shape a new donor recognition and retention proposition that will improve access and engagement of donors, and build a more sustainable donor base. These pilots will play a critical role in shaping a scheme that supports NHSBT’s goals of equitable access, long-term engagement, and sustainability in blood donation.

Whether he has made an assessment of the potential impact of introducing non-cash incentives for voluntary blood donors on donation volumes.

NHS Blood and Transplant (NHSBT) is responsible for blood services in England. NHSBT has a Donor Recognition Scheme (DRS) that thanks donors, using personalised emails at various milestones, digital badges, and for higher donation thresholds, distributes pin badges and formal certificates. Further information on the DRS is available at the following link:https://www.blood.co.uk/the-donation-process/recognising-donors/NHSBT’s strategic objective is to grow and diversify the donor base to meet evolving hospital needs, and to reduce health inequalities. To support this, the DRS is being reviewed. The new approach will shift the emphasis from recognition alone to retention, with a stronger focus on engaging newer donors. In the coming year, a series of pilots will shape a new donor recognition and retention proposition that will improve access and engagement of donors, and build a more sustainable donor base. These pilots will play a critical role in shaping a scheme that supports NHSBT’s goals of equitable access, long-term engagement, and sustainability in blood donation.

What recent discussions he has had with the Minister for Women and Equalities on access to fertility treatment for same sex couples.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has not had recent discussions with the Minister for Women and Equalities on access to fertility treatment for same sex couples.

What steps his Department is taking to ensure that patients continue to receive ADHD medication without cost when their shared care agreement has come to an unpredicted end.

It is the responsibility of integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including access to medication services for attention deficit hyperactivity disorder (ADHD). Services are underpinned by relevant guidance from the National Institute for Health and Care Excellence (NICE), which provides evidence-based guidance for the health and care system on best practice.It is for the responsible clinician to decide on the most appropriate treatment plan to manage ADHD, in discussion with their patient. This decision is based on the clinician’s expertise regarding treatment options, evidence, risk and benefits and the patient’s personal circumstances as part of a shared decision-making process. The NICE guideline on the diagnosis and management of ADHD provides recommendations that healthcare professionals should account for when considering treatment options.Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as prescription of medication, over to the patient’s general practitioner (GP).The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. Shared care is not part of the GP contract and as such, participation is voluntary. GP practices may decline such requests on clinical or capacity grounds. A GP who has previously agreed to a shared care agreement but can no longer support it must provide a clear rationale for their decision. Both the GP and the specialist clinician share responsibility for ensuring continuity of care for the patient.ADHD medication prescribed by an NHS doctor is subject to prescription charging, unless the patient meets the criteria for a prescription charge exemption. This is the case regardless of a shared care agreement being in place.

What steps he is taking to help establish specialist care pathways for people with bipolar to (a) improve treatment and (b) reduce the levels of misdiagnosis

We recognise that there can often be a long time taken to diagnose bipolar disorder because of under-reporting, the episodic nature of the condition, and the prevalence of comorbid conditions in individuals.We are committed to increasing access to community mental health services for people with severe mental illness, including those with bipolar disorder. The community mental health framework, developed by NHS England, sets out the National Health Service’s vision for transforming community mental health services. This includes ensuring that services are needs led and that individuals do not require a specific diagnosis or care pathway to access care.

What steps his Department is taking to help reduce the average time taken to diagnose bipolar disorder in line with early intervention targets for other conditions

We recognise that there can often be a long time taken to diagnose bipolar disorder because of under-reporting, the episodic nature of the condition, and the prevalence of comorbid conditions in individuals.We are committed to increasing access to community mental health services for people with severe mental illness, including those with bipolar disorder. The community mental health framework, developed by NHS England, sets out the National Health Service’s vision for transforming community mental health services. This includes ensuring that services are needs led and that individuals do not require a specific diagnosis or care pathway to access care.

What training is provided to early intervention in psychosis teams on (a) recognising and (b) supporting people with bipolar.

We recognise how important it is for individuals with bipolar to get the right care and support they need. NHS England commissions training for staff working in early intervention in psychosis services to deliver cognitive behavioural therapy for both psychosis and bipolar disorder.Mental health professionals are required to complete core training as part of their roles, which includes information on awareness of bipolar disorder and how it presents. The comprehensive assessment of at-risk mental states is an assessment tool used by mental health professionals and researchers to identify individuals who are at high risk of developing psychosis.

Whether he has made an assessment of the potential merits of extending Early Intervention in Psychosis services to include people with bipolar who do not experience psychosis.

Early Intervention in Psychosis services provide evidence-based, specialist interventions, and treatment for individuals presenting with psychosis. These services recognise that bipolar disorder diagnoses can be uncertain and are therefore available to individuals irrespective of their diagnosis, including individuals experiencing bipolar 1 and bipolar 2.The aim is for individuals who experience psychosis as part of a manic episode to be seen by an early intervention in psychosis service within two weeks of referral. If an individual experiences mood disturbance over time, bipolar disorder may be identified and treated.Early Intervention in Psychosis services are not affective disorder services. It would therefore not be appropriate to extend services to individuals who are not experiencing psychosis. Individuals with bipolar 2 who do not experience mania or psychosis will receive support and treatment from primary care and community mental health teams as appropriate.

If he will publish rates of sectioning under the Mental Health Act 1983 by diagnosis of (a) bipolar and (b) other mental health conditions for each of the last five years.

An individual is detained under the Mental Health Act 1983 if they pose a serious risk to themselves or others and they require care in a hospital setting. Detentions are not made based on diagnoses of severe mental health conditions.NHS England is currently exploring a methodology to analyse diagnoses of individuals detained under the Mental Health Act and initial results are expected to be published in May 2025. Therefore, the information requested is not available for the last five years.

With reference to the Answer of 7 May 2024 to 24262, whether the Innovative Devices Access Pathway pilot will conclude in March 2025; and what his planned timetable is for assessing the findings of the pilot.

The Innovative Devices Access Pathway (IDAP) pilot will conclude in March 2025. We are continuing to seek feedback from the pilot, which will capture key insights and learnings to help inform the feasibility and development of a future pathway. This will inform a wider evaluation of IDAP. We will complete this evaluation soon after the conclusion of the pilot and intend to publish a report in spring.

What steps his Department is taking to help tackle the public health risks associated with high levels of nitrogen oxide pollution from diesel vehicles.

Despite significant progress, air pollution remains a significant environmental threat to human health. Leading our Health Mission, the Department of Health and Social Care is working across Government, including with the Department for Transport, to promote a reduction in the health harms of air pollution.Tackling the public health risks associated with air pollution involves reducing concentrations of pollutants where people live, work and play. Local authorities have an important role in identifying and implementing the local measures needed to achieve legal air quality limits and clean up the air we breathe. The NO2 programme has provided £575 million to support local authorities to address nitrogen dioxide pollution and achieve compliance with legal limits in the shortest possible time, supporting measures such as Clean Air Zones, traffic management improvements and vehicle upgrade schemes, and recently agreeing Greater Manchester’s £86 million Clean Air Plan.

What assessment his Department has made of the potential impact of excess diesel emissions from vehicles using defeat devices on (a) the prevalence of respiratory diseases and (b) public health.

Diesel vehicles significantly impact air pollution in the United Kingdom, primarily through emissions of nitrogen oxides (NOₓ) and particulate matter. Poor air quality is one of the largest environmental risks to public health in the UK, and epidemiological studies have shown that long-term exposure to air pollution, over years or lifetimes, reduces life expectancy, mainly due to cardiovascular and respiratory diseases and lung cancer. Short-term exposure, over hours or days, to elevated levels of air pollution can also cause a range of health impacts, including effects on lung function, exacerbation of asthma, increases in respiratory and cardiovascular hospital admissions and mortality.The Department for Transport is responsible for setting and enforcing standards for NOx emissions from diesel vehicles. The Market Surveillance Unit within the Driver and Vehicle Standards Agency is undertaking a programme looking at possible non-compliant diesel emissions in Euro 5 and Euro 6A/B/C diesel cars and vans where there is reason to believe that they contain a prohibited defeat device. The programme is designed to ensure any non-compliance found is fixed as soon as reasonably possible, working together with manufacturers to achieve real-world impacts on air quality. There is no current assessment of the potential health impacts specifically related to the use of defeat devices in diesel vehicles.

What assessment he has made of the potential impact of recent trends in the level of funding for elective services on ADHD right to choose assessments.

Elective funding covers a range of planned health services, including elective ordinary and day cases, outpatient appointments, and diagnostics tests, although this does not include attention deficit hyperactivity disorder (ADHD) services. ADHD patients continue to benefit from the right to choose their provider at the point of referral.It is the responsibility of the integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including assessments for ADHD, in line with relevant National Institute for Health and Care Excellence guidelines.NHS England has established a taskforce which is working to bring together those with lived experience, and experts from the National Health Service, education, charity, and justice sectors. The taskforce is working to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, and is expecting to report in the summer of 2025.In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also conducted detailed work to understand the provider and commissioning landscape, capturing examples from ICBs who are trialling innovative ways of delivering ADHD services. NHS England is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.

What recent assessment he has made of the adequacy of midwife training with respect to (a) pay and (b) conditions and (i) the impact to the profession and (ii) the care that expectant parents receive.

In addition to the student loans system, there is supplementary financial support available from the Department to midwifery students through the NHS Learning Support Fund (LSF). The LSF provides eligible midwifery students with a non-repayable training grant of £5,000 per academic year, with further financial support depending on personal circumstances. The Government keeps the funding arrangements for all healthcare students under close review to strike a balance between ensuring that students are financially supported during their studies and delivering maximum value for money for the taxpayer. Apprenticeship opportunities are also available for those for whom a full-time university course is not practical or preferred, as well as postgraduate conversions and return to midwifery programmes.Approved Education Institutions and practice partners are responsible for developing the content and design of academic and practice-based learning programmes in line with the standards of proficiency, conduct, and performance of midwives, as set out by the Nursing and Midwifery Council (NMC). The NMC approves these programmes and ensures the quality of practice placements for students. It would not be appropriate for the Government to intervene in this process, and we respect the independence and expertise of universities and regulators in designing standards that ensure public safety, including the safety of expectant parents.

What steps his Department is taking to help ensure that disabled children from all socio-economic backgrounds receive appropriate therapy.

The Government is committed to championing the rights of disabled people, and will break down the barriers to opportunity and ensure that every child has the best start in life. This includes all children and young people with Special Educational Needs and Disabilities (SEND).Across England, community health services, including therapies, are locally commissioned to enable systems to best meet the needs of their communities. We are working closely with NHS England to improve access to community health services and on actions to reduce long waits.The Children and Families Act 2014 requires that education, health, and social care services work together to meet the needs of children and young people with SEND. In May 2023, NHS England issued statutory guidance setting out the requirement for integrated care boards (ICBs) to have an executive lead for SEND, who will lead on supporting the Chief Executive and the board to ensure the ICB performs its functions effectively in the interests of children and young people with SEND.

If he will make it his policy to conduct a review of the medicines supply chain to ensure that the causes of ongoing shortages of medicines for (a) epilepsy, (b) Parkinson’s and (c) ADHD are (i) understood and (ii) addressed.

The resilience of United Kingdom’s supply chains is a key priority, and the Department and NHS England are committed to helping to build long term supply chain resilience for medicines. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and strengthen our resilience.The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, some issues, including with some carbamazepine, lamotrigine, and oxcarbazepine presentations, have been resolved.We are aware of an ongoing supply issue with all strengths of topiramate tablets, with the resupply date to be confirmed. Other manufacturers of topiramate tablets can meet the increased demand during this time.The Department is aware of supply constraints with one supplier of amantadine 100miligram capsules used in the management of Parkinson’s Disease, however stocks remain available from alternative suppliers to cover demand. The Department has also been notified of a discontinuation of apomorphine (APO-go PFS) 50 milligram/10mililitre pre-filled syringes from April 2025. Alternative formulations of apomorphine remain available for patients and management guidance has been issued to the National Health Service. The Department has also been working hard with industry and NHS England to help resolve the supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved, and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.We are intensively working to resolve issues with methylphenidate prolonged-release tablets by collaborating with current and new suppliers, expanding the UK supplier base, and partnering with NHS England to improve demand forecasting for ADHD medicines.