Written questions by Davies.

What steps his Department plans to take to support colonoscopy services following the extension of the Bowel Cancer Screening Programme to include people aged 50-74.

The age extension for bowel screening started in April 2021 with the 56 year old cohort and, based on modelling and clinical advice, has followed the planned gradual reduction to age 50 by 2025. This has been done to ensure that screening centres could manage the required increase in colonoscopy capacity.Services have increased screening capacity. Screening and symptomatic endoscopy services are working closely together as part of the ongoing endoscopy transformation of symptomatic pathways, which aims to release colonoscopy capacity through, for example:the use of the faecal immunochemical test as a clinical triage tool in accordance with National Institute for Health and Care Excellence guidance;the use of alternative imaging modalities such as colon capsule endoscopy/computed tomography colonography; andthe use of other pre diagnostic tools such as the capsule sponge.Bowel cancer screening is a crucial aspect of prevention, helping identify apparently healthy people who may have an increased risk of a particular condition, preventing bowel cancer and promoting earlier diagnosis and detection. NHS England is committed to delivering bowel cancer screening uptake across the whole population and is working to reduce inequalities. As part of this, NHS England is developing public communications to increase awareness of screening amongst younger age groups, particularly in those 50 years old and over cohorts, who are newly eligible. This includes updating online and digital channels and working with key external stakeholders.

What steps his Department plans to take to encourage uptake of the Bowel Cancer Screening Programme to people aged 50 following the reduction of age eligibility.

The age extension for bowel screening started in April 2021 with the 56 year old cohort and, based on modelling and clinical advice, has followed the planned gradual reduction to age 50 by 2025. This has been done to ensure that screening centres could manage the required increase in colonoscopy capacity.Services have increased screening capacity. Screening and symptomatic endoscopy services are working closely together as part of the ongoing endoscopy transformation of symptomatic pathways, which aims to release colonoscopy capacity through, for example:the use of the faecal immunochemical test as a clinical triage tool in accordance with National Institute for Health and Care Excellence guidance;the use of alternative imaging modalities such as colon capsule endoscopy/computed tomography colonography; andthe use of other pre diagnostic tools such as the capsule sponge.Bowel cancer screening is a crucial aspect of prevention, helping identify apparently healthy people who may have an increased risk of a particular condition, preventing bowel cancer and promoting earlier diagnosis and detection. NHS England is committed to delivering bowel cancer screening uptake across the whole population and is working to reduce inequalities. As part of this, NHS England is developing public communications to increase awareness of screening amongst younger age groups, particularly in those 50 years old and over cohorts, who are newly eligible. This includes updating online and digital channels and working with key external stakeholders.

What steps his Department is taking to ensure (a) early diagnosis and (b) specialist treatment pathways for patients with Adrenal Cancer.

The Government recognises that diagnosing and treating rare cancers, including adrenal cancer, can be difficult due to their non-specific symptoms, which are often shared with other more common conditions.To support earlier diagnosis, the National Health Service is improving referral and diagnostic pathways, including the use of non-specific symptom pathways for patients whose symptoms, such as unexplained weight loss, fatigue, or abdominal discomfort, do not clearly align with a single cancer type, but which may indicate a rare cancer like adrenal cancer. NHS England has also expanded general practice direct access to diagnostic tests, enabling faster investigation of concerning symptoms.We are committed to transforming diagnostic services and will support the NHS to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners. Community diagnostic centres will also help reduce the number of patients waiting too long for a confirmed cancer diagnosis, and will ensure capacity is available for both common and rare cancers.To improve access to timely treatment, the NHS is delivering an additional 40,000 operations, scans, and appointments each week. The forthcoming National Cancer Plan will set out further actions to improve outcomes for cancer patients, including those with rare and less common cancers. It will focus on speeding up diagnosis and treatment, and ensuring access to the latest treatments and technologies for all.

What steps he is taking to support research into Adrenal cancer through (a) funding, (b) clinical trials and (c) collaboration with academic institutions.

Research is crucial in tackling cancer, which is why the Department invests £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer as one of the largest areas of spend at over £133 million in 2023/24, reflecting its high priority. The NIHR funds research and research infrastructure, which supports patients and the public to participate in high-quality research.The NIHR welcomes funding applications for research into any aspect of human health, including research into adrenal cancer. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.The NIHR also welcomes applications for training awards from the clinical and non-clinical academic workforce conducting research into any aspect of human health, including adrenal cancer. The Department is the United Kingdom’s largest funder of clinical academic training, working with academic institutions and the wider health and care system to deliver a comprehensive research career pathway for the full range of clinicians.The Department is committed to working with delivery partners, including the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, and other key stakeholders, to achieve the common aim of creating a faster, more efficient, more accessible, and more innovative clinical research delivery system. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the UK, so that we can provide innovative treatment options for patients, including those with adrenal cancer.

What steps NHS England plans to take to improve (a) awareness and (b) training for (i) GPs and (ii) frontline healthcare professionals to better (A) recognize and (B) refer suspected cases of adrenal cancer.

General practitioners (GPs) are responsible for ensuring their own clinical knowledge, including on adrenal cancer, 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, to ensure that they can continue to provide high quality care to all patients.The training curriculum for postgraduate trainee doctors is set by the Royal College of General Practitioners (RCGP), and has to meet the standards set by the General Medical Council. The RCGP provides a number of resources on cancer prevention, diagnosis, and care for GPs, relevant for the primary care setting.NHS England supports initiatives aimed at enhancing early cancer diagnosis and awareness among healthcare professionals. These initiatives include GatewayC, an online education platform providing modules on early cancer diagnosis for primary care professionals, and the Aspirant Cancer Career and Education Development programme, designed to improve cancer-related knowledge and capabilities across the non-medical workforce. These measures aim to equip GPs and frontline professionals with the skills necessary to identify and act on potential cancer symptoms, including those of rare cancers such as adrenal cancer.

What steps his Department is taking to improve the collection and reporting of age-disaggregated data on participation in cancer clinical trials, in addition to collecting participation data through NIHR.

The National Institute for Health and Care Research (NIHR), funded by the Department, funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including cancer clinical trials.The NIHR Research Delivery Network collects age-disaggregated data on participation in cancer clinical trials across all age groups, for studies supported by NIHR infrastructure, and reports on this data where appropriate.The Department is working with NHS England and other partners to develop a new data collection approach which will include the age of people participating in NIHR funded studies, including for cancer clinical trials. Once established, this could be expanded to include age data from studies supported by other funders.The Department is committed to maximising the United Kingdom’s potential to lead the world in clinical research, with the aim of ensuring that all patients, including those with cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.

What assessment he has made of the potential impact of age-related eligibility criteria on the inclusion of teenagers and young adults in cancer clinical trials.

The Department is committed to maximising the United Kingdom’s potential to lead the world in clinical research, with the aim of ensuring that all patients, including teenagers and young adults with cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.The eligibility of patients for a clinical trial is determined by a set of criteria designed to ensure the safety of participants and the scientific validity of the study. These criteria are decided by each study's sponsors and researchers, based on scientific evidence, study goals, and safety considerations.The Department is working closely with the National Health Service, industry, academia, research regulators, and charities to make clinical research in the UK more efficient, more competitive, and more accessible. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the UK, including clinical trials for teenagers and young adults with cancer.The Department funded National Institute for Health and Care Research funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including clinical trial participation for young people with cancer.

What the evidential basis is for age-based exclusion criteria in cancer clinical trials; and what steps his Department is taking to ensure that young people have equitable access to participation in such trials.

The Department is committed to maximising the United Kingdom’s potential to lead the world in clinical research, with the aim of ensuring that all patients, including teenagers and young adults with cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.The eligibility of patients for a clinical trial is determined by a set of criteria designed to ensure the safety of participants and the scientific validity of the study. These criteria are decided by each study's sponsors and researchers, based on scientific evidence, study goals, and safety considerations.The Department is working closely with the National Health Service, industry, academia, research regulators, and charities to make clinical research in the UK more efficient, more competitive, and more accessible. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the UK, including clinical trials for teenagers and young adults with cancer.The Department funded National Institute for Health and Care Research funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including clinical trial participation for young people with cancer.

What steps he plans to take to ensure the gonorrhoea vaccination programme reaches (a) young people aged 15-24 (b) women, (c) gay, bisexual, and other men who have sex with men and (d) other communities most at risk.

In November 2023, the Joint Committee on Vaccination and Immunisation (JCVI) issued advice on standing up a targeted, routine vaccination programme for protection against gonorrhoea.Officials across the Department, the UK Health Security Agency and NHS England have been developing options based on the JCVI advice, assessing all the relevant factors to ensure that the United Kingdom’s high standards for world-leading vaccination programmes are maintained, and the best value for money for taxpayers is delivered. A decision on a vaccination programme for the prevention of gonorrhoea is expected shortly, following the outcome of this process.NHS England will work with partners across national, regional, and local levels to ensure that plans for any new vaccination programme will meet local need, ensure equity of access and support a high level of uptake of the vaccination offer by those who are eligible.

What steps his Department plans to take to implement the targeted roll-out of the Gonorrhoea vaccine.

In November 2023, the Joint Committee on Vaccination and Immunisation (JCVI) issued advice on standing up a targeted, routine vaccination programme for protection against gonorrhoea.Officials across the Department, the UK Health Security Agency and NHS England have been developing options based on the JCVI advice, assessing all the relevant factors to ensure that the United Kingdom’s high standards for world-leading vaccination programmes are maintained, and the best value for money for taxpayers is delivered. A decision on a vaccination programme for the prevention of gonorrhoea is expected shortly, following the outcome of this process.NHS England will work with partners across national, regional, and local levels to ensure that plans for any new vaccination programme will meet local need, ensure equity of access and support a high level of uptake of the vaccination offer by those who are eligible.

What steps he is taking to improve the geographical spread of cancer clinical trial sites to enable equitable access for teenagers and young adults.

The Department is committed to maximising the United Kingdom’s potential to lead the world in clinical research, with the aim of ensuring that all patients, including teenagers and young adults with cancer, have access to cutting-edge clinical trials and innovative, lifesaving treatments.The National Institute for Health and Care Research (NIHR), funded by the Department, funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including clinical research for teenagers and young adults with cancer.This research infrastructure includes a network of Experimental Cancer Medicine Centres, co-funded by the NIHR, Cancer Research UK, and the Little Princess Trust, which work across the whole of the UK, bringing together world-leading laboratory and clinical researchers to test new treatments for adults and children with cancer.The NIHR Research Delivery Network (RDN) supports patients, the public, and health and care organisations across England to participate in high-quality research. The RDN consists of 12 regional RDNs, which support sites across England to deliver clinical research, including clinical research for teenagers and young adults with cancer.The newly designated Commercial Research Delivery Centres (CRDCs) will build further capacity in delivering commercial clinical research. There are 21 CRDCs spread across the UK, and one of the CRDCs, based at the Sheffield Children’s NHS Foundation Trust, is dedicated to the delivery of commercial clinical trials for treating children and young people.

What assessment his Department has made of the effectiveness of the Yorkshire Outreach Programme for leukaemia monitoring; and whether he plans to roll that programme out nationally.

The Department commends the Yorkshire Outreach Programme for leukaemia monitoring, which supports more than 3,500 people across the region, and will consider the programme as we develop a new National Cancer Plan to improve patient outcomes.For early-stage blood cancers, including leukaemia, early treatment is not always beneficial, with national and international clinical guidelines advising life-long monitoring to enable prompt intervention in the small group of patients who eventually need treatment. Models for monitoring these patients differ across England, with cancer alliances and integrated care boards rolling out programmes they have evaluated and have shown to improve benefits to patients, with oversight from NHS England.The National Health Service is committed to ensuring that cancer patients have access to personalised care, including a needs assessment, a care plan, and health and wellbeing information and support. Personalised care includes provision of information, empowering people to manage their care and the impact of their cancer, ensuring that each person’s care is planned holistically, covering mental and physical health as well as any practical or financial concerns.

Whether he plans to take steps to enable all patients to book primary care appointments through the NHS app.

Currently, patients can book general practitioner (GP) appointments via the NHS App. Availability of GP appointments is dependent on practices making their appointments available online. Many practices use triage processes to make an initial assessment of patients’ needs, rather than making online appointments available with a GP on a ‘first come first served’ basis. Routine or planned appointments that do not require prior assessment, such as cervical screening, asthma reviews or regular B12 injections, are more likely to be made available in the NHS App.Work is underway to understand how the NHS App can support patients, who have been triaged and assessed as needing an appointment, with the ability to find and book an appropriate appointment.

Whether his Department has taken steps to provide forums for (a) officials and (b) Ministers to learn from international examples of best practice in the delivery of healthcare.

The Department routinely engages with partners from overseas to share knowledge and best practice, to support strategy and policy development across the Department.As part of the 10-Year Health Plan engagement exercise, we have been working with international experts to understand different countries’ approaches to delivering healthcare, and the three shifts at the centre of the plan, from hospital to community, from analogue to digital, and from sickness to prevention. In March, the Department jointly hosted two ministerial led roundtables with WHO EURO and Kings College London, where international experts shared experiences of implementing the three shifts. Attendees from around the world included former ministers, government officials, academics, and health system experts, to provide expert insight into international best practice.

If he will make an assessment of the potential implications for his policies of variations in commissioning by integrated care systems of digital solutions for primary care.

Integrated care boards (ICBs) are the responsible commissioning bodies for digital technology in general practice. ICBs support practices to source the digital tools and services they need to deliver the requirements of the GP contract, as set out in the GP IT Operating Model. They also help practices with business change, training and optimisation to help practice staff use new technology safely and effectively.NHS England provides commercial and procurement support to help ICBs ensure all digital solutions in general practice meet nationally specified clinical safety and technical standards, and minimum capabilities to support the digitally enabled shift to modern general practice. Within this, practices have flexibility, working with their ICB, to deploy different solutions to best meet their local patient care needs.Within the community pharmacy sector, funding of up to £8 million has been secured to support digital developments as part of the recently agreed Community Pharmacy Contractual Framework (CPCF) for 2025/26. Through the CPCF, the Department and NHS England have expressed their commitment to continuing to work with the pharmacy sector and IT suppliers to streamline the ‘Manage Your Service’ claim process through using payment and data APIs, for all national clinical services.

How much funding his Department has committed to suicide prevention in the 2025-26 financial year.

Funding for suicide prevention is included in baseline National Health Service funding for mental health services, and is not separately identified.Between 2019/20 and 2023/24, additional funding of £57 million was provided through the NHS Long Term Plan to embed local suicide prevention activity and suicide bereavement support services in every local authority area.In addition, the Department provided £5.4 million of funding in 2021/22 and £10 million from 2023 to 2025 through grant schemes targeted at national and local voluntary community and social enterprise sector organisations delivering suicide prevention activity.A further £550,000 of funding was also provided to the Local Government Association in 2021/22 for a support programme to help local authorities strengthen their suicide prevention plans.Integrated care boards, previously clinical commissioning groups, are responsible for providing health and care services to meet the needs of their local populations, and it is up to them to decide how much funding to allocate to suicide prevention services in 2025/26.

How much funding his Department has provided for suicide prevention (a) nationally and (b) locally in each financial year since 2015-16.

Funding for suicide prevention is included in baseline National Health Service funding for mental health services, and is not separately identified.Between 2019/20 and 2023/24, additional funding of £57 million was provided through the NHS Long Term Plan to embed local suicide prevention activity and suicide bereavement support services in every local authority area.In addition, the Department provided £5.4 million of funding in 2021/22 and £10 million from 2023 to 2025 through grant schemes targeted at national and local voluntary community and social enterprise sector organisations delivering suicide prevention activity.A further £550,000 of funding was also provided to the Local Government Association in 2021/22 for a support programme to help local authorities strengthen their suicide prevention plans.Integrated care boards, previously clinical commissioning groups, are responsible for providing health and care services to meet the needs of their local populations, and it is up to them to decide how much funding to allocate to suicide prevention services in 2025/26.

Pursuant to the Answer of 10 March to Question 34747, whether it remains his Department's policy to reach full rollout of lung cancer screening to the eligible population by 2029.

The National Health Service is taking crucial steps to improve cancer outcomes across England, including for lung cancer. The NHS Lung Screening Cancer Programme is designed to catch more cancers earlier when they are more treatable, with the hope of saving more lives. The target is to be available to 100% of the population by the end of 2029/30.

If he will ensure that the planned reductions in headcount in NHS England and his Department do not result in disruption to the implementation of lung cancer screening.

Ministers and senior Department officials will work with the new executive team at the top of NHS England, led by Sir Jim Mackey, to jointly lead this transformation. This reform is about devolving resources and responsibility to the frontline, thereby empowering staff to focus on delivering better care for patients.As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will put plans in place to ensure continuity of care. We recognise the importance of lung cancer screening and are committed to ensuring its continuity during the transformation.

Pursuant to the Answer of 10 March to Question 34747, when responsibility for oversight and funding of the National Lung Screening Programme will transfer from NHS England to his Department.

Ministers and senior Department officials will work with the new executive team at the top of NHS England, led by Sir Jim Mackey, to jointly lead this transformation. This reform is about devolving resources and responsibility to the frontline, thereby empowering staff to focus on delivering better care for patients.As we work to return many of NHS England’s current functions to the Department, we will ensure that we continue to evaluate impacts of all kinds, and will put plans in place to ensure continuity of care. We recognise the importance of lung cancer screening and are committed to ensuring its continuity during the transformation.