Written questions by Prinsley.

What recent estimate his Department has made of the number of people waiting to undergo otolaryngology surgery.

Otolaryngology surgery is listed under Ear, Nose and Throat (ENT) data for recording purposes. As of November 2024, the waiting list for ENT stood at 633,270. This marked a decrease of 4,380 compared to October 2024. As of November 2024, 49.2% of pathways were within 18 weeks. Not all the patients on the waiting list will have a “decision to treat”. Tackling waiting lists, including in ENT, 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, equivalent to 40,000 per week, as a first step in our commitment to ensuring patients can expect to be treated within 18 weeks. The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS Constitutional Standard that 92% of patients wait no longer than 18 weeks from referral to treatment by the end of this Parliament and ensure patients have the best possible experience of care. The Elective Reform Plan commits to the following actions to reform outpatient services, including increasing uptake of Advice and Guidance and triage to reduce unnecessary demand on elective services, reducing low value follow up appointments, minimising missed appointments to maximise clinical time, and reforming clinical pathways to improve efficiency in five priority specialties, one of which is ENT.

What steps his Department is taking to help inform people of the potential risks of of undertaking (a) cosmetic or (b) elective surgery overseas.

The Government has engaged, and continues to engage, with partners to develop, update and promote key messages on public facing guidance. We worked closely with the Foreign, Commonwealth and Development Office to develop guidance for its online travel advice page. We have engaged with NHS England to update guidance on the National Health Service website, and we have liaised with the General Medical Council, the Royal College of Surgeons, and the British Association of Plastic, Reconstructive and Aesthetic Surgeons about providing information online to support consumers to make safe choices about any cosmetic procedure they may choose to undergo abroad.Government advice to anyone considering medical treatment abroad is to carefully research the treatment in question, the qualifications of the chosen clinician overseas, the regulations that apply in the country in question, and ensure appropriate aftercare both abroad and once back in the United Kingdom.We also encourage people to review the Government’s travel advice, the relevant guidance from the NHS, and other relevant professional bodies. Foreign, Commonwealth and Development Office travel advice has been updated to highlight the issue and steer British nationals towards appropriate advice. This also includes advice to consider appropriate insurance cover, as a specialist policy will be required if medical treatment is planned abroad.

What steps his Department is taking to help reduce elective surgery waiting lists in Bury St Edmunds and Stowmarket constituency.

The Elective Reform Plan, launched as part of the Government’s Plan for Change, sets out how we will get back to the NHS Constitutional Standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment by the end of this Parliament, and will also ensure that patients have the best possible experience of care. We have set an ambition for 2025/26 that we reach 65% of patients waiting no longer than 18 weeks nationally, and for all trusts to deliver a minimum 5% improvement by March 2026. We will also publish minimum standards of care that patients can expect to experience, and will make digital improvements, including to the NHS App, to provide patients with greater choice, control, and flexibility.At the Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer announced an additional £1.5 billion in funding to support National Health Service performance across secondary and emergency care, including for surgical hubs. We will set out details of the allocation of funding for surgical hubs at the earliest opportunity, including details and locations of surgical hubs. Trusts with no operational or planned surgical hubs will be prioritised for new hub funding, as well as trusts with the highest waiting lists.Across the country, dedicated and protected surgical hubs are transforming the way the NHS provides elective care, by focussing on high volume low complexity surgeries. The Bury St Edmunds and Stowmarket constituency falls under the Suffolk and North East Essex Integrated Care Board. They have two recently opened surgical hubs, one in Ipswich, which opened in July 2024, and the second is the Essex and Suffolk Elective Orthopaedic Centre ESEOC, which opened in November 2024.

What steps his Department is taking to increase training facilities for surgeons in the East of England.

All local education providers, including in the East of England, are responsible for ensuring they have the appropriate capacity, including facilities, for training staff, including surgeons.The General Medical Council’s (GMC’s) Promoting excellence: standards for medical education and training sets out the standards that the GMC expects organisations responsible for educating and training medical students and doctors in the United Kingdom to meet. This includes having the capacity, resources, and facilities to deliver safe and relevant learning opportunities, clinical supervision, and practical experiences for learners.NHS England’s Education Quality Framework states that all staff, including learners and educators, should have access to the necessary resources, facilities, and equipment to ensure their safety within the workplace and to deliver safe clinical care. The framework is monitored locally in collaboration with medical schools. In addition, NHS England’s NHS Education Funding Agreement sets out in detail the expectations around the premises and facilities of placement providers.

What steps he is taking to ensure (a) expertise and (b) public confidence are retained in Hyperbaric Oxygen Therapy services available on the NHS.

NHS England is currently reviewing the service provision and national service specification for Hyperbaric Oxygen Therapy Services, used to clearly define the standards of care expected from organisations funded by NHS England to provide specialised care, due to the current service contracts expiring during 2025. Revisions to service specification follow the published process, which supports appropriate stakeholder engagement and governance. More information on the process is available at the following link:https://www.england.nhs.uk/publication/methods-national-service-specifications/NHS England has considered the feedback received from the recent public consultation on the Hyperbaric Oxygen Therapy Services revised service specification, alongside other sources of evidence, to inform its plans for the service re-procurement. The outcome of this will be made available in due course.Further, NHS England is required to commission services, including Hyperbaric Oxygen Therapy Services, in line with the National Health Service’s triple aim of improving health outcomes, improving quality of care and ensuring value for the system.

What steps his Department is taking to ensure compliance with the Accessible Information Standard across the NHS.

National Health Service organisations and publicly funded social care providers must comply with the Accessible Information Standard (AIS), to meet the communication needs of patients and carers with a disability, impairment, or sensory loss. The AIS conformance criteria, published in 2016, set out how organisations should comply with the AIS, with further information available at the following link:https://www.england.nhs.uk/about/equality/equality-hub/patient-equalities-programme/equality-frameworks-and-information-standards/accessibleinfo/resources/assess-conformance/The responsibility for monitoring compliance with the AIS sits with the commissioner of the service.NHS England is responsible for the AIS, and has completed a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. One of the aims of the review was to strengthen assurance of implementation of the AIS, and a self-assessment framework has been developed to support providers of NHS and social care services to measure their performance against the AIS, and develop improvement action plans to address gaps in implementation. The AIS self-assessment framework is designed to enable enhancements around assurance, and allows organisations, commissioners, and the Care Quality Commission to judge performance and compliance.A revised AIS is being reviewed with a view to publication, and in the meantime NHS England is continuing to work to support implementation with awareness raising, communication and engagement, and a review of the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using these services.

When he plans to implement section 95 of the Health and Care Act 2022.

The Department plans to commence section 95 in 2025. This will be subject to Parliament’s approval of the regulations setting out the procedure for preparing and publishing mandatory information standards, which are a necessary part of the package of measures introduced by section 95.

What assessment his Department has made of the adequacy of compliance with the Accessible Information Standard in the NHS.

National Health Service organisations and publicly funded social care providers must comply with the Accessible Information Standard (AIS), to meet the communication needs of patients and carers with a disability, impairment, or sensory loss. The AIS conformance criteria, published in 2016, set out how organisations should comply with the AIS, with further information available at the following link:https://www.england.nhs.uk/about/equality/equality-hub/patient-equalities-programme/equality-frameworks-and-information-standards/accessibleinfo/resources/assess-conformance/The responsibility for monitoring compliance with the AIS sits with the commissioner of the service.NHS England is responsible for the AIS, and has completed a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. One of the aims of the review was to strengthen assurance of implementation of the AIS, and a self-assessment framework has been developed to support providers of NHS and social care services to measure their performance against the AIS, and develop improvement action plans to address gaps in implementation. The AIS self-assessment framework is designed to enable enhancements around assurance, and allows organisations, commissioners, and the Care Quality Commission to judge performance and compliance.A revised AIS is being reviewed with a view to publication, and in the meantime NHS England is continuing to work to support implementation with awareness raising, communication and engagement, and a review of the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using these services.

Whether he plans to (a) bring forward legislative proposals to further regulate and (b) publish guidance on the (i) definition of the scope of practice and (ii) supervisory requirements for physician associates.

The legislation to introduce statutory regulation for Physician Associates (PAs) and Anaesthesia Associates (AAs) was debated in the Scottish Parliament and both Houses of Parliament earlier this year.Regulation by the General Medical Council (GMC) will begin in December 2024. The GMC will set standards of practice, education, and training, and will operate fitness-to-practice procedures to ensure that PAs and AAs can be held to account if serious concerns are raised.Whilst statutory regulation is an important part of ensuring patient safety, it is also achieved through robust clinical governance processes within healthcare organisations, which are required to have systems of oversight and supervision for their staff.NHS England has issued clear guidance on the deployment of PAs and AAs in the National Health Service, which describes the expectations of how organisations providing NHS care should deploy them so that they can contribute to the delivery of safe and effective healthcare in a supportive environment. This guidance is available at the following link:https://www.england.nhs.uk/long-read/summary-of-existing-guidance-on-the-deployment-of-medical-associate-professions-in-nhs-healthcare-settings/

What assessment he has made of the impact of plans to outsource hundreds of staff by East Suffolk and North Essex NHS Foundation Trust on (a) NHS services and the (b) healthcare workforce.

Contract award decisions in the National Health Service fall directly to individual NHS bodies, which are responsible for running their own procurement exercises. Ministers do not have general powers in legislation to direct NHS trusts in relation to the exercise of any of their functions, including in relation to specific contractual decisions. The NHS has established governance processes, in line with Government procurement policy and best practice, to assure that appropriate contractual decisions are made and represent value for money.East Suffolk and North Essex NHS Foundation Trust has advised the Department and NHS England that no final decision has been taken yet for the future provision of ‘Soft’ Facilities Management services across the trust’s sites. Staff and their Union representatives affected by the proposals have been fully consulted as the trust has progressed its plans. All the options in a formal Full Business Case (FBC) will be considered, following receipt and evaluation of bids received from potential external suppliers. The trust is not obliged to accept any of the bids submitted unless they clearly demonstrate value for money and deliver against the aims and objectives of the business cases.