Written questions by Heylings.

What assessment he has made of the adequacy of the provision of specialist training opportunities for young doctors; and whether he has plans to increase the availability of these opportunities.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it.  We will ensure that the number of medical specialty training places meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest. We have launched the 10-Year Health Plan which will set out a bold agenda to reform and repair the NHS. Ensuring we have the right people, in the right places, with the right skills will be central to this vision. In summer 2025, we will publish a refreshed Long Term Workforce Plan to build the transformed health service we will deliver over the next decade.

What assessment he has made of the effectiveness of NHS England in upholding (a) article 5 and (b) article 6 of the UK's General Data Protection Regulation.

The Department requires all health and care organisations, including NHS England, to annually assess themselves against the standards set out in the Data Security and Protection Toolkit (DSPT). The DSPT measures health and care organisations’ data protection and security capability and preparedness. The requirement to comply with Articles 5 and 6 of the UK General Data Protection Regulation (GDPR) are embedded in the standards required by the DSPT.NHS England has consistently met the requirements of the DSPT, including its most recent assessment in June 2024.In addition, NHS England provides a safe haven for National Health Service data in accordance with the Department’s statutory guidance, NHS England’s protection of patient data. The guidance ensures that NHS England acts as a safe and effective guardian of information collected from the NHS and adult social care services.As part of its compliance with Article 5 of the UK GDPR, NHS England ensures transparency in its use of personal data by publishing data protection impact assessments and a monthly data uses register that details all external data sharing agreements.

How the NHS England Consultation on changes to Right to Choose under the NHS Payment Scheme Policy will take into account the views of patients and their families.

NHS England has followed standard procedure in its consultation on the NHS Payment Scheme. A consultation on changes to the payment scheme takes place every year as required to by law. While the legal requirement is to consult commissioners and providers, the views of patients and their families are important and responses are therefore accepted from other interested parties and members of the public. Responses will inform further decisions on the final scheme design.

What steps his Department is taking to help increase the supply of prescription medicines in (a) rural and (b) other areas.

Integrated care boards are responsible for understanding the health needs of their areas and commissioning services to meet those needs. Local authorities are required to undertake a pharmaceutical needs assessment every three years, to assess whether their population is adequately served, and must keep these assessments under review. These assessments inform integrated care boards when they are reviewing applications for National Health Service pharmacies. The Pharmacy Access Scheme provides additional funding to pharmacies in areas where there are fewer pharmacies. In rural areas where there are no pharmacies, general practices are permitted to dispense medicines. Patients can also choose to access medicines and pharmacy services through any of the nearly 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.Medicine supply chains are complex, global, and highly regulated, and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, difficulties in access to raw materials, sudden demand spikes or distribution issues, and regulatory issues. We have drawn on up-to-date intelligence and data on the root causes of medicine supply issues, with manufacturing problems being the most dominant root cause.Most supply issues can be managed to avoid shortages, and while we can’t always prevent supply issues from occurring, we have a range of well-established processes and tools to manage them when they arise and mitigate the risks to patients.The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within individual pharmacies is not held centrally.The resilience of UK’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. We are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. 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. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver solutions.

How many and what proportion of continuing care assessments resulted in eligibility in (a) the Cambridgeshire and Peterborough Integrated Care Board and (b) England in the most recent year for which figures are available.

We have interpreted the request for information regarding continuing care assessments as a request for data on NHS Continuing Healthcare (CHC) eligibility decisions for standard CHC. The following data is based on the number of assessments completed and the number and proportion found eligible:- from 1 April 2023 to 31 March 2024, 157 assessments out of a total of 638 standard CHC assessments, or 25%, resulted in eligibility in the Cambridgeshire and Peterborough Integrated Care Board area; and- from 1 April 2023 to 31 March 2024, 10,791 assessments out of a total of 51,165 standard CHC assessments, or 21%, resulted in eligibility in England.

If he will review the decrease to the Agenda For Change mileage payments for community nurses that will come in July 2025.

Agenda for Change mileage reimbursement rates are reviewed twice a year in line with the process set out in the national contract. These reviews incorporate the latest information on the cost of fuel. The next review is scheduled for April 2025 and any changes required would then be implemented in July 2025. We cannot pre-empt the outcome of this review, however it does not necessarily mean that changes will be made to the reimbursement rates.The Government is aware that some National Health Service trusts may have local arrangements in place for reimbursing mileage. This would be for local employers and trade unions to manage in partnership.

What steps his Department is taking to increase day care outpatient provision for the treatment of (a) children, (b) young people and (c) adults with eating disorders.

NHS England is refreshing guidance on children and young people's eating disorders, to increase the focus on early identification and intervention and to shift away from inpatient care to community-based care models, including day hospitals/outpatient services.Updated guidance will highlight the importance of improved integration between dedicated community eating disorder services, outpatient day services, wider children and young people's mental health and neurodevelopmental services, schools, colleges and primary care to reduce the need for inpatient stays. The guidance will also improve awareness, provide expert advice and improve support for children and young people presenting with problems with eating, whilst ensuring swift access to specialist support as soon as an eating disorder is suspected.Since April 2021, all integrated care systems have received fair shares funding to transform their adult community mental health services, including eating disorders. NHS England has also published guidance to support systems with implementing intensive day patient care.

What steps his Department is taking to reduce waiting times for (a) GP referral for assessment, (b) assessment and (c) treatment for patients with eating disorders.

General practice (GP) is the front door to the National Health Service, and we know that patients are struggling to see a GP. We are committed to fixing this and delivering the care that patients deserve. That is why, in October 2024, we provided an £82 million boost to the Additional Roles Reimbursement Scheme enabling the recruitment of 1,000 newly qualified GPs across England. This will increase the number of GP appointments delivered, which will benefit thousands of patients seeking access to GP care. We will also bring back the family doctor by incentivising continuity of care so patients can see the same doctor at each appointment, which is key to managing and supporting patients with conditions, including eating disorders.The Department continues to work closely with NHS England to ensure that people with an eating disorder get the care and treatment they need. NHS England is continuing to expand community-based eating disorder services’ capacity. This includes crisis care and intensive home treatment, to improve outcomes and recovery, reduce rates of relapse, prevent eating disorders continuing into adulthood. Also, if admission is required as a very last resort, reduce lengths of stay.

What his planned timetable is for providing national coverage for fracture liaison services.

We remain committed to rolling out Fracture Liaison Services across every part of the country by 2030.In the meantime, we are investing in 13 high-tech bone density DEXA scanners, which are expected to provide an extra 29,000 scans to ensure people with bone conditions get diagnosed earlier.

If he will make an assessment of the adequacy of the (a) funding and (b) availability of the Sleepio app for people with insomnia.

There is currently no central funding from NHS England to support the national commissioning of digital cognitive behavioural therapy for insomnia to integrated care boards.Sleepio remains available for local commissioning by integrated care systems, should they choose to commission this product, as part of local insomnia care and treatment pathways.No further assessments relating to the funding or availability of this product at a national level are currently planned.

What assessment he has made of the adequacy of the availability of NHS cognitive behavioural therapy for insomnia; and whether he plans to increase the coverage of that therapy.

It is for local integrated care boards to decide whether cognitive behavioural therapy should be offered to their local populations as a treatment for insomnia. NHS Talking Therapies for anxiety and depression offers low-intensity therapy which may include interventions around sleep hygiene. Individuals who are experiencing symptoms of anxiety and/or depression can self-refer to NHS Talking Therapies, with further information available at the following link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/ Individuals can also access helpful resources on sleep problems on the Every Mind Matters website, which is available at the following link:https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/

If he will make an assessment of the potential merits of shingles vaccines for all over 65s.

From September 2023, the routine shingles vaccination programme changed from the Zostavax vaccine to the two dose Shingrix vaccine, to better protect individuals from the effects of shingles, provide better clinical outcomes, and reduce pressures on the health system. The programme was also expanded, and as a result, almost 1 million more people became eligible for the shingles vaccination.The expansion of the shingles programme currently includes those turning 65 years old on or after 1 September 2023, as well as those aged 50 years old and over who are at increased risk of serious complications. Once everyone aged 65 to 70 years old has received the vaccine, the eligible age will be reduced to 60 years old. Phasing the roll-out of the shingles vaccination over time to everyone aged 60 years old maximises cost effectiveness and population benefit, ensures consistent messaging over time to maximise coverage, and takes account of National Health Service capacity, all while being consistent with the approach taken by all four nations in the United Kingdom. This is a newly expanded programme, and anyone unsure if they are eligible for the shingles vaccination should check online, on the NHS.UK website, or should speak to their general practice.In November, the Joint Committee on Vaccination and Immunisation provided advice to the Department on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over. The Department will consider this advice and will update in due course.

If he will publish a new dementia strategy which references the use of music to support people living with dementia.

The National Institute for Health and Care Excellence’s Quality Standard on Dementia, published in June 2019, recommends that therapeutic use of music be considered as a means of non-pharmacological intervention for people with dementia. Localities should take account of this guidance.The Department funds research on the use of musical techniques for people living with dementia via the National Institute for Health and Care Research. This includes a major study investigating how music therapy can reduce patient distress and physical assaults on National Health Service inpatient wards for people with dementia. The study is called MELODIC, and will create a programme of music therapy which will be piloted on two NHS mental health wards at the Cambridgeshire and Peterborough NHS Foundation Trust.

If he will publish a social care strategy which includes support for the use of musical techniques for people living with dementia.

The National Institute for Health and Care Excellence’s Quality Standard on Dementia, published in June 2019, recommends that therapeutic use of music be considered as a means of non-pharmacological intervention for people with dementia. Localities should take account of this guidance.The Department funds research on the use of musical techniques for people living with dementia via the National Institute for Health and Care Research. This includes a major study investigating how music therapy can reduce patient distress and physical assaults on National Health Service inpatient wards for people with dementia. The study is called MELODIC, and will create a programme of music therapy which will be piloted on two NHS mental health wards at the Cambridgeshire and Peterborough NHS Foundation Trust.

What steps he plans to take to improve the (a) diagnosis and (b) treatment of Lyme disease.

There are several studies and projects being undertaken in the United Kingdom looking at the prevalence and distribution of Lyme disease. Examples include two studies undertaken in association with National Institute of Health Research. One is focussing on studying the evolution of the disease in patients, and the second is examining the evidence of exposure to the Lyme disease bacteria in the English population.Clinical advice for general practitioners (GPs) and hospital physicians on Lyme disease is available from the National Health Service. Most cases are diagnosed based on clinical signs by GPs, and laboratory testing is widely available for more complicated cases.The UK Health Security Agency (UKHSA) provides Lyme disease laboratory testing services for England and Wales and issues detailed advice on sample testing.Lyme disease is treatable with a course of antibiotics in accordance with national guidelines. However, if left untreated, the infection can spread to affect the nervous system, joints, or the heart. More information on the diagnosis and treatment of Lyme disease is available at the following link:https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis#laboratory-diagnosisThe UKHSA’s Be Tick Aware toolkit provides information resources to enable local stakeholders to deliver public health information on ticks and tick-borne disease prevention directly to their population and visitors. The toolkit is available at the following link:https://assets.publishing.service.gov.uk/media/642e966bfbe620000f17ddbe/Be_tick_aware_toolkit.pdf