Written questions by Davies.

What steps his Department is taking to reduce death rates from (a) alcohol, (b) drugs and (c) suicide in (a) the North and (b) coastal regions.

A vital part of delivering the Health Mission shift to prevention will be action to reduce the number of deaths due to alcohol and drug use, especially in deprived areas. In England, rates of drug poisoning and drug misuse deaths have a marked north-south divide, with the North East of England having consistently seen the highest rate of drug and alcohol deaths over the previous decade.The Department is continuing to invest in improvements to local drug and alcohol treatment and recovery services to ensure that those in need can access high quality help and support. The Office for Health Improvement and Disparities has an action plan to reduce drug and alcohol-related deaths, which is being reviewed in light of the recent Office of National Statistics data, to ensure that it is grounded in the latest understanding of the drivers of drug and alcohol related deaths, and is responding to these. Additionally, the Office for Health Improvement and Disparities has published Commissioning quality standard: alcohol and drug services, which provides guidance for local authorities to support them in commissioning effective alcohol and drug treatment and recovery services in their areas. Further information on the guidance is available at the following link:https://www.gov.uk/government/publications/commissioning-quality-standard-alcohol-and-drug-servicesThe Department continues to work with all local areas to address unmet need and drug and alcohol misuse deaths, and to drive improvements in the continuity of care. This includes the Unmet Need Toolkit which can be used by local areas to assess local need and the causes of mortality, in order to plan to meet it.Earlier this year the Department published guidance for local authorities and their partnerships on how to review adult drug and alcohol-related deaths and near-fatal overdoses to prevent future deaths. This is available at the following link:https://www.gov.uk/government/publications/preventing-drug-and-alcohol-deaths-partnership-review-process/preventing-drug-and-alcohol-deaths-partnership-review-processIt also published guidance on incident planning and preparedness for the emerging threat of potent synthetic opioids.As part of the NHS Long Term Plan, over £30 million of national funding has been invested between 2019 and 2025, on an ambitious programme to establish new, or optimise existing, Alcohol Care Teams (ACTs) in the 25% hospitals with the highest need, which is 47 out of 188 eligible sites in England. The ACTs identify people in hospital whose ill health is related to alcohol use, commence treatment for alcohol dependence, and refer to community alcohol treatment on discharge.The Government has committed to tackling suicide as one the biggest killers in this country. The 8,500 new mental health workers we will recruit will be specially trained to support people at risk to reduce the lives lost to suicide. The Suicide Prevention Strategy for England, published in September 2023, identifies a number of targeted actions at a national level. We are exploring opportunities to go further.79 organisations have been allocated funding up to March 2025 from the £10 million Suicide Prevention Grant Fund and are delivering a broad and diverse range of activity that will prevent suicides and save lives including in the North and in coastal areas. Organisations benefitting include Lancaster Men’s Hub, Stockton and District Advice and Information Service, and Cornwall Neighbourhoods for Change Ltd.

If he will make an estimate of the projected net NHS spend on medicines (a) before and (b) after accounting for forecast rebates due via the (i) Voluntary Scheme for Branded Medicines Pricing, Access and Growth and (ii) Branded Health Service Medicines (costs) Regulations 2018 for the next five years.

Annex 3 of the document titled Annexes to the 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth outlines the forecasts of measured sales and payments from branded medicines. This document is available at the following link:https://assets.publishing.service.gov.uk/media/657b2993254aaa000d050de1/Annexes-2024-voluntary-scheme-for-branded-medicines-pricing-access-and-growth.pdf

If he will publish a breakdown of the cost to the public purse of NHS spend on (a) branded pharmaceuticals, (b) generic pharmaceuticals and (c) companion diagnostics in the last 12 months.

On 7 November 2024, the NHS Business Service Authority published data on the costs of medicines, appliances, dressings, and medical devices prescribed within primary and secondary care in England. This report is available at the following link:https://www.nhsbsa.nhs.uk/statistical-collections/prescribing-costs-hospitals-and-community-england/prescribing-costs-hospitals-and-community-england-2023-24.A breakdown of the prescribing costs in England between branded and generic medicines is available for primary care only, and can be found at the following link:https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england/prescription-cost-analysis-england-202324.Such publications do not account for income received under the 2024 voluntary scheme for branded medicines pricing, access, and growth (VPAG) or the statutory scheme. Information on how the VPAG and the statutory scheme, which operate United Kingdom-wide, control the cost of sales of branded medicines to the National Health Service is available at the following link:https://www.gov.uk/government/collections/voluntary-scheme-quarterly-net-sales-and-payment-informationVPAG and statutory scheme sales data does not reflect the total cost to the NHS. The publication reports net sales of non-exempt products and non-exempt companies only, and is exclusive of additional costs such as pharmacy and wholesaler margins.

What steps he plans to take to ensure that the priorities of (a) children and (b) young people with cancer are included within the ten-year plan.

We are committed to getting the National Health Service diagnosing cancer earlier and treating it faster, so that more patients survive this horrible set of diseases. This includes children, teenagers, and young adults.The Department is taking steps to improving waiting times for cancer diagnosis across all cancer patient groups in England. We will start by delivering an extra 40,000 scans, appointments, and operations each week to ensure that patients are seen as quickly as possible.We are also working with the NHS to maximise the pace of the roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres, with capacity prioritised for cancer. This will help us continue to meet the Faster Diagnosis Standard, which aims to ensure that over 75% patients have cancer diagnosed or ruled out within 28 days of referral from a general practice (GP) or screening service.To support timely and effective referrals, the National Institute for Health and Care Excellence has set out detailed guidance for GPs on the symptoms of cancer in children and young people, recommending referral within 48 hours for those presenting with a range of potential cancer symptoms.Lord Darzi’s independent investigation into the NHS highlighted that there is more to be done to increase the speed at which patients are diagnosed with and treated for cancer. His report will inform our 10-year plan to reform the NHS, which will include further details on how we will improve cancer diagnosis, treatment, and outcomes. This includes children and young people.On 21 October 2024, the Department launched a national engagement exercise to inform the plan. We encourage people and organisations who would like to share their views on the priorities of children and young people with cancer to do so via the online platform, change.NHS.UK. Following the engagement exercise, the Department will carefully consider how the priorities of this group should be reflected in the plan and any subsequent work.

What steps he is taking to improve (a) diagnosis and (b) referral rates for 13–24-year-olds with cancer.

We are committed to getting the National Health Service diagnosing cancer earlier and treating it faster, so that more patients survive this horrible set of diseases. This includes children, teenagers, and young adults.The Department is taking steps to improving waiting times for cancer diagnosis across all cancer patient groups in England. We will start by delivering an extra 40,000 scans, appointments, and operations each week to ensure that patients are seen as quickly as possible.We are also working with the NHS to maximise the pace of the roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres, with capacity prioritised for cancer. This will help us continue to meet the Faster Diagnosis Standard, which aims to ensure that over 75% patients have cancer diagnosed or ruled out within 28 days of referral from a general practice (GP) or screening service.To support timely and effective referrals, the National Institute for Health and Care Excellence has set out detailed guidance for GPs on the symptoms of cancer in children and young people, recommending referral within 48 hours for those presenting with a range of potential cancer symptoms.Lord Darzi’s independent investigation into the NHS highlighted that there is more to be done to increase the speed at which patients are diagnosed with and treated for cancer. His report will inform our 10-year plan to reform the NHS, which will include further details on how we will improve cancer diagnosis, treatment, and outcomes. This includes children and young people.On 21 October 2024, the Department launched a national engagement exercise to inform the plan. We encourage people and organisations who would like to share their views on the priorities of children and young people with cancer to do so via the online platform, change.NHS.UK. Following the engagement exercise, the Department will carefully consider how the priorities of this group should be reflected in the plan and any subsequent work.

What progress his Department has made on the NHS Long Term plan target of increasing clinical trial participation for children and young people with cancer to 50% by 2025.

The Department is committed to maximising our potential to lead the world in clinical trials and ensuring clinical trials are more accessible, including for children and young people. The Department does not hold data on the overall percentage of children and young people with cancer that are enrolled in clinical trials nationwide, but does collect data on participation through National Institute for Health and Care Research (NIHR) funded infrastructure.The Department funds research and research infrastructure through the NIHR. NIHR-funded infrastructure is enabling clinical trial participation for children and young people with cancer. In particular, the NIHR Clinical Research Network, now the NIHR Research Delivery Network, supported 117 cancer studies which children and young people were eligible for between 2021/22 and 2023/24, and across all these studies, 6904 total participants were recruited during this timeframe.Through the NIHR, the Department also jointly funds the Experimental Cancer Medicine Centre Paediatric Cancer Network with Cancer Research UK and the Little Princess Trust, which brings together clinicians and translational scientists to run early phase clinical trials for children and young people with cancer.

Whether he plans to introduce a national plan to tackle shortages of pancreatic enzyme replacement therapy.

The Department has been working with suppliers to address current supply issues with Creon, which is a brand of pancreatic enzyme replacement therapy (PERT) used by patients with conditions such as cystic fibrosis and certain cancers including pancreatic cancer. The supply issues with Creon are impacting countries throughout Europe and have been caused by limited availability of raw ingredients and manufacturing capacity constraints to produce volumes needed to meet demand. These issues have resulted in knock-on supply disruptions of alternative PERT medications. The Department is continuing to work with all suppliers of PERT to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets, and increase production.The supplier of Creon has advised that they expect to have regular supplies released each month going forward, and are working to increase the quantities released. Serious Shortage Protocols are in place for Creon 10,000 and 25,000 capsules which pharmacists can use to restrict supply to one month at a time to ensure more patients have access to it whilst stock is limited.We have worked closely with colleagues in NHS England to issue comprehensive guidance to healthcare professionals about these supply issues, and encourage sharing of local solutions. The guidance provides advice on how to manage patients whilst there is disruption to supply and is being kept under review, with updates made as necessary.

What steps his Department is taking to improve maternity services in the West Yorkshire region.

We are committed to improving maternity and neonatal services across the country, to ensure that all women and babies receive the care they deserve. The West Yorkshire and Harrogate Local Maternity and Neonatal System (LMNS), as part of the West Yorkshire Integrated Care Board, focuses on transforming maternity services through NHS England’s three-year delivery plan, ensuring that care is personalised, and women are listened to. Further information is available at the following link:https://www.wypartnership.co.uk/our-priorities/maternityThe West Yorkshire and Harrogate LMNS has multiple working groups, which focus on the four key themes of the three-year delivery plan. This work includes implementing the Saving Babies Lives Care Bundle version 3, which is a package of initiatives designed to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth, and meeting the requirements of the Maternity Incentive Scheme which provides financial incentives for trusts to meet certain safety requirements.The LMNS has oversight and assurance through various metrics including clinical outcome data, workforce data, patient and staff surveys, a health inequalities dashboard, and a perinatal quality surveillance model.

Pursuant to the Answer of 4 October 2024 to Question UIN 7300on Visual Impairment: Rehabilitation, what evidence informed his Department's decision not to regulate vision rehabilitation specialists.

The Government has made no assessment of the potential merits of extending statutory regulation to vision rehabilitation specialists. Whilst statutory regulation is sometimes necessary where significant risks to users of services cannot be mitigated in other ways, it is not always the most proportionate means of ensuring public protection.

What assessment his Department has made of he potential merits of introducing Mental Health Support teams in every school.

The Department is working across the Government to consider how to deliver on our commitment of a specialist mental health professional in every school. We need to ensure that any support meets the needs of young people, teachers, parents, and carers. This includes considering the role of existing programmes of support with evidence of a positive impact, such as Mental Health Support Teams in schools and colleges.

What steps the Government is taking to improve breast cancer screening in Colne Valley constituency.

NHS England has developed a national plan in collaboration with key stakeholders, including Cancer Alliances, to improve uptake within the breast screening programme. The plan sets out the priorities and interventions, as well as the required monitoring of the impacts and outcomes to be achieved, to improve uptake through expanding access, data, analytics, contracting, communication, and IT developments, while reducing inequalities.On a local level, the Kirklees Health and Care Partnership has worked with local public health services to collaborate with homes and neighbourhood housing, to identify areas of low uptake of breast, bowel, and cervical screening, and areas of deprivation combined with areas of council housing. This has resulted in homes and neighbourhood staff actively delivering a pilot focused on promoting the benefits and importance of screening. Working with tenants to understand their level of understanding of screening, their challenges, and the barriers to attendance, and working to overcome these barriers.Local public health services have also recently launched a breast screening campaign titled Don’t let it be you, which aims to encourage people eligible for breast screening to go for their screening, and not ignore their letter.

If he will make a comparative assessment of the adequacy of access to mental health provision in (a) urban and (b) rural areas.

Integrated care boards are responsible for providing health and care services to meet the needs of their local populations, taking into account local considerations such as access to services in rural areas.Too many people are not receiving the mental health care they need, and we know that waits for mental health services are too long. We are determined to change that, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health. This should help people in rural areas to be confident in accessing high quality mental health support when they need it.We will recruit an additional 8,500 mental health workers across child and adult mental health services in England to reduce delays and provide faster treatment, including in rural areas. We will make sure mental health care is delivered in the community and close to people’s homes, through new models of care and support, so that fewer people need to go into hospital.

What steps he is taking to ensure parity in the adequacy of mental health resources in (a) rural and (b) urban areas.

Integrated care boards are responsible for providing health and care services to meet the needs of their local populations, taking into account local considerations such as access to services in rural areas.Too many people are not receiving the mental health care they need, and we know that waits for mental health services are too long. We are determined to change that, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health. This should help people in rural areas to be confident in accessing high quality mental health support when they need it.We will recruit an additional 8,500 mental health workers across child and adult mental health services in England to reduce delays and provide faster treatment, including in rural areas. We will make sure mental health care is delivered in the community and close to people’s homes, through new models of care and support, so that fewer people need to go into hospital.

What steps he is taking to help ensure that local solutions to manage shortages of Pancreatic Enzyme Replacement Therapy are shared nationally.

The Department has been working with suppliers to address current supply issues with Creon, which is used by patients with conditions such as cystic fibrosis and certain cancers including pancreatic cancer. The supply issues with Creon are impacting countries throughout Europe and have been caused by limited availability of raw ingredients and manufacturing capacity constraints to produce volumes needed to meet demand. These issues have resulted in knock-on supply disruptions of alternative pancreatic enzyme replacement therapy medications. The Department is continuing to work with all suppliers of pancreatic enzyme replacement therapy to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets, and increase production.The supplier of Creon has advised that they expect to have regular supplies released each month going forward and are working to increase the quantities released. Serious Shortage Protocols are in place for Creon 10,000 and 25,000 capsules which pharmacists can use to restrict supply to one month at a time to ensure more patients have access to it whilst stock is limited.We have worked closely with colleagues in NHS England to issue comprehensive guidance to healthcare professionals about these supply issues and encourage sharing of local solutions. The guidance provides advice on how to manage patients whilst there is disruption to supply and is being kept under review, with updates made as necessary.

What steps he has taken to improve awareness of the hereditary risk of pancreatic cancer.

NHS England is taking steps to deliver a range of interventions to improve awareness of the hereditary risk of pancreatic cancer. This includes providing a route into pancreatic cancer surveillance for those at inherited high-risk, to identify lesions before they develop into cancer. Through local Cancer Alliances, NHS England is working to spread knowledge across NHS providers about hereditary pancreatic cancer risks.NHS England is working with Pancreatic Cancer UK to develop a public-facing Family History Checker, which enables people, and their families affected by pancreatic cancer, to self-assess if they have inherited risk. People identified at risk are referred directly to European Registry of Hereditary Pancreatic Diseases research trail, which aims to understand inherited conditions of the pancreas. Referrals to the trail can be made by any healthcare professional across all health sectors, or by individuals via self-referral.

What his planned timetable is for implementing the proposed changes to (a) vision rehabilitation services and (b) professional recognition.

We do not currently have plans to regulate Vision Rehabilitation Specialists. The Care Act guidance advises that local authorities should consider securing specialist qualified rehabilitation and assessment provision, whether in-house, or contracted through a third party, to ensure that the needs of people with sight loss are correctly identified and their independence maximised.

What steps he plans to take to improve the integration of services between secondary and social care settings to ensure a seamless route into vision rehabilitation.

The Department understands the importance of having effective rehabilitation services available when people need them to help them recover and return to their day-to-day activities and regain their quality of life.People who have sight loss to the degree they are certified as blind or partially sighted will receive a certificate of visual impairment (CVI). With the patient’s permission the CVI form is shared with a person’s local authority to help facilitate access to social care support. In accordance with the Care and support statutory guidance, local authorities should offer to carry out a needs assessment with a view to providing a care and support plan aimed at meeting any identified needs. The guidance is available at the following link:https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidanceStatutory integrated care systems are partnerships of organisations which come together to plan and deliver joined up health and care services. An integrated approach to person-centred care can enable a seamless route for patients coming out of hospital into social care. This helps to make sure people get the right support from health and social care services to return home as soon as possible, including patients requiring vision rehabilitation.

If he will take steps to ensure that vision rehabilitation services are subject to the same (a) regulation and (b) monitoring as other adult social care services.

Under the Care Act 2014, local authorities in England have a legal duty to support people with sight loss to develop practical skills and strategies to maintain independence.The Care Quality Commission (CQC) is now assessing how local authorities are meeting the full range of their duties under Part 1 of the Care Act 2014. These assessments identify local authorities’ strengths and areas for development, facilitating the sharing of good practice and helping us to target support where it is most needed. This will also facilitate the development of national standards as part of our steps towards creating a National Care Service.Therefore, although CQC is not currently required to assess vision rehabilitation services as regulated activities under Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, sensory services, including vision rehabilitation, do form part of CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice or an area for improvement.Our new Client Level Data collection requires local authorities to collect person-level information covering most of their activity under Part 1 of the Care Act 2014. Information on visual impairments is voluntary at this stage, but this will be kept under review.

What steps his Department is taking to improve prostate cancer (a) screening and (b) awareness in Colne Valley constituency.

Screening for prostate cancer is currently not recommended by the UK National Screening Committees. This is because of the inaccuracy of the current best test, the Prostate Specific Antigen (PSA). A PSA-based screening programme could harm men, as some of them would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments which can also have harmful side effects.NHS England runs Help Us Help You campaigns to increase knowledge of cancer symptoms, address barriers to acting on them to encourage people to come forward as soon as possible to see their general practitioner. The campaigns focus on a range of symptoms as well as encouraging ‘body awareness’ to help people spot symptoms across a wide range of cancers at an earlier point.

If he will make an assessment of the potential merits of making vision rehabilitation specialists a regulated profession.

We do not currently have plans to regulate vision rehabilitation specialists.