Written questions by Gilmour.

If his Department will make an assessment of the potential merits of providing medical exemptions to access NHS care for dental injuries caused as a result of epileptic seizures.

There are currently no plans to extend the list of people eligible for free National Health Service dental care to include those with dental injuries caused by epileptic seizures. Free NHS dental care is available to people who meet one of the following criteria: under 18, or under 19 and in full-time education; pregnant or have had a baby in the previous 12 months; being treated in an NHS hospital and the treatment is carried out by the hospital dentist, keeping in mind that patients may have to pay for any dentures or bridges; and receiving low-income benefits, or under 20 and a dependant of someone receiving low-income benefits.Support is also available through the NHS Low Income Scheme for those patients who are not eligible for exemption or full remission of dental patient charges. More information is available at the following link: https://www.nhs.uk/nhs-services/dentists/who-is-entitled-to-free-nhs-dental-treatment-in-england/ Community dental services provide specialised dental services to people with additional needs and are available in a variety of places to ensure everyone can have access to dental care. These include hospitals, specialists’ health centres and mobile clinics, as well as home visits or visits in nursing and care homes. These services may be available to people with epilepsy, depending on their needs.

If he will make an assessment of the adequacy of the provision of emergency back up generators in rural (a) hospitals and (b) GP surgeries.

No national assessment has been made of the provision of emergency backup generators in hospitals and general practice surgeries. It is the responsibility of each National Health Service provider to have resilience plans and procedures in place.Guidance is provided to the NHS within the Health Technical Memorandum 06 series, namely Health Technical Memorandum 06-01: Electrical services supply and distribution, Health Technical Memorandum 06-02: Electrical safety guidance for low voltage systems, and Health Technical Memorandum 06-03: Electrical safety guidance for high voltage systems, which are all respectively available at the following three links:https://www.england.nhs.uk/publication/electrical-services-supply-and-distribution-htm-06-01/https://www.england.nhs.uk/publication/electrical-safety-guidance-for-low-voltage-systems-htm-06-02/https://www.england.nhs.uk/publication/electrical-safety-guidance-for-high-voltage-systems-in-healthcare-premises-htm-06-03/This guidance is for healthcare organisation, defined as an organisation that provides or intends to provide healthcare services, and is therefore applicable to primary and secondary care providers.

What data his Department holds on confirmed cases of waterborne illness linked to exposure to (a) Salmonella and (b) Leptospira at UK bathing waters since 2020.

There have been no reported outbreaks of salmonella spp. associated with recreational water use in the time period requested since 2020.The UK Health Security Agency (UKHSA) undertakes surveillance of Salmonella spp. infections. No information is available on the suspected cause of gastrointestinal infection for individual cases, unless salmonellosis cases are epidemiologically linked to an outbreak.The UKHSA also undertakes routine surveillance for leptospirosis infections in humans, and publishes a quarterly report on the common animal-associated infections, with further information available at the following link:https://www.gov.uk/government/publications/common-animal-associated-infections-2024/common-animal-associated-infections-england-second-quarter-2024#leptospirosisExposure history is not well reported by cases. Water sources may be in the United Kingdom or abroad, and do not necessarily reflect where the infection was acquired. The following table shows the most recent figures of confirmed cases of leptospirosis in each quarter, from Quarter one of 2020 to Quarter two of 2024:Year20202021202220232024Confirmed leptospirosis cases5154527030Potential exposure to water source181716216

What steps his Department is taking to increase levels of funding for research into essential tremors.

The Department funds research through the National Institute for Health and Care Research (NIHR). The NIHR is supporting research that involves essential tremors and has awarded £2,814,334 for related studies in the last five years. The NIHR welcomes funding applications for research into any aspect of health and care, including essential tremors, and research topic proposals can be made to the NIHR via the following link: https://www.nihr.ac.uk/get-involved/suggest-a-research-topic Funding applications to the NIHR 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.

What steps he plans to take through the 10 Year Health Plan to support community pharmacies.

The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and community pharmacies will have a big role to play in that shift.As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, with input from the public, patients, health staff, and our partners, including from the community pharmacy sector.

What steps his Department is taking to help people with arthritis to stay physically active.

Guidance published by the National Institute for Health and Care Excellence on the diagnosis and management of osteoarthritis recommends therapeutic exercise for all people with osteoarthritis that is tailored to their needs and that is part of a wider structured treatment package. It advises that for people with osteoarthritis, long-term adherence to an exercise plan can help to reduce pain and increase functioning and quality of life. The guidance is available at the following link:https://www.nice.org.uk/guidance/ng226More widely, the Government and the National Health Service recognise the important role of physical activity in the prevention and management of long-term health conditions, including arthritis. The NHS Better Health Campaign promotes ways for adults, families and children to move more, and signposts people, including those living with long term conditions who are ready to build movement into their routine, to digital support like the NHS Active 10 walking app.Local authorities and the NHS also promote and provide services for people living with long term conditions, such as exercise on referral and social prescribing, including access to physical activity interventions, falls prevention and walking groups.The Department, with Sport England, has delivered support and training to equip healthcare professionals to enable patients to move more to improve their physical and mental health. Sport England continues to support work in this area through the Physical Activity Clinical Champions programme, which is currently being piloted in local areas.NHS England is working closely with partners nationally and locally to explore how the NHS might galvanise support to make physical activity a core part of NHS care to benefit patients, NHS staff, and the wider public.

Whether his Department plans to publish (a) an arthritis action plan and (b) other disease-specific action plans following publication of the NHS 10 Year Health Plan.

There are currently no plans to publish an arthritis action plan following the publication of the 10-Year Health Plan.Services for those with musculoskeletal (MSK) conditions, including arthritis, are commissioned locally by integrated care boards (ICBs). The Department expects MSK services to be fully incorporated into integrated care system planning and decision-making.As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) MSK Community Delivery Programme. With a £3.5 million funding boost, GIRFT teams will deploy their proven Further Faster model to work with ICB leaders to further reduce MSK community waiting times, including for those with arthritis, and improve data and metrics, and referral pathways to wider support services.To support health and care professionals in the early diagnosis and management of rheumatoid arthritis and osteoarthritis, and in the provision of services for people living with arthritis, the National Institute for Health and Care Excellence has published expert guidance for rheumatoid arthritis and osteoarthritis, with further information on both available, respectively, at the following two links:https://www.nice.org.uk/guidance/ng100https://www.nice.org.uk/guidance/ng226

What steps his Department is taking to help prevent community pharmacy closures in (a) rural and (b) deprived areas.

Pharmacies play a vital role in our healthcare system, and the Government recognises the integral role they play within our communities, as an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals. We have secured a funding uplift for the profession that brings the core budget to £3,073 million from 2025/26. This represents a significant growth of 19.7% in 2023/24. Community pharmacies are private businesses that provide NHS funded services. Most pharmacies are not directly commissioned or contracted by the NHS, instead contractors apply to gain entry to the NHS pharmaceutical list and if an application is approved, a pharmacy can open and start providing services. Local authorities are required to undertake a pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served by local pharmacies, and must keep these assessments under review. Integrated care boards (ICBs) give regard to the PNAs when reviewing applications from the new contractors. Contractors can also apply to open a new pharmacy to offer benefits to patients that were not foreseen by the PNA. If there is a need for a new local pharmacy to open and no contractors apply to open a pharmacy and fill the gap, ICBs can commission a new pharmacy to open outside of the market entry processes, and fund the contract from the ICB’s budgets. The Pharmacy Access Scheme helps protect access to pharmacies in areas where there are fewer pharmacies and higher health needs, so that no area is left without access to local, physical NHS pharmaceutical services.

What assessment he has made of the potential impact of the discharge process on patients in cross-county areas.

Enabling people to be discharged from hospital more quickly and with the right support contributes to speedier recovery and better outcomes. In some instances, this may mean discharging a patient outside of their local area so that they can receive the most appropriate short-term care after discharge. Some hospitals have excellent relationships and processes for cross-county discharges, although we know that in other instances these can cause delays whilst the care transfer hub determine responsibility for funding post discharge care.The Hospital Discharge and Community Support Guidance sets out that integrated care boards and local authorities should agree local arrangements to ensure that any decisions about the joint funding of care can be made swiftly. These arrangements should follow the ‘Who Pays?’ guidance for services funded by the National Health Service, and reference ‘ordinary residence’ rules for services funded by local authorities, so that there is no adverse effect on timely discharge. Both sets of guidance are available at the following links:https://www.gov.uk/government/publications/hospital-discharge-and-community-support-guidance/hospital-discharge-and-community-support-guidancehttps://www.england.nhs.uk/publication/who-pays-determining-which-nhs-commissioner-is-responsible-for-commissioning-healthcare-services-and-making-payments-to-providers/

What assessment he has made of the potential implications for his policies the (a) side effects and (b) long-term health implications of the use of clozapine as a medicament.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines and medicinal products and ensures that the product information for each medicines reflects what is known about the medicine and provides information to support safe use and minimise risks. The product information consists of the Summary of Product Characteristics for healthcare professionals and the patient information leaflet supplied in each pack of medicine.Clozapine was first authorised in 1989 and is now indicated for treatment-resistant schizophrenic patients and in schizophrenia patients who have severe, untreatable neurological adverse reactions to other antipsychotic agents, including atypical antipsychotics. Treatment resistance is defined as a lack of satisfactory clinical improvement despite the use of adequate doses of at least two different antipsychotic agents, including an atypical antipsychotic agent, prescribed for adequate duration.Clozapine is also authorised to treat psychotic disorders occurring in patients with Parkinson's disease, in cases where standard treatment has failed. Clozapine is associated with several potentially serious side effects which are outlined in the product information, that require monitoring of various aspects of patient’s health to minimise risks including monitoring: white blood cells, blood pressure, heart function, liver function, body weight, glucose, cholesterol, other medication, falls and for signs of infection.As clozapine is used when other treatments have failed to manage a patient’s condition, careful monitoring is required to minimise the risks to ensure patients are able to receive effective treatment with clozapine.The safety of clozapine is continuously monitored by the MHRA to ensure the product information reflects what is known about the medicine. The MHRA is in the process of reviewing the blood monitoring requirements and will be seeking views in the summer from patients, patients’ families and healthcare professionals on methods to improve awareness of the risks associated with clozapine and how to manage them.

What steps his Department is taking to support people with postural tachycardia syndrome.

Improving health outcomes for people who live with long-term conditions, including postural tachycardia syndrome, is a key part of the Government's mission to build a National Health Service fit for the future. The National Institute for Health and Care Excellence (NICE) publishes guidance on the diagnosis and treatment of long-term conditions for use by healthcare professionals and commissioners. NICE has produced a clinical knowledge summary on the clinical management of blackouts and syncope, which sets out how clinicians should assess and diagnose postural tachycardia syndrome. This was last updated in November 2023 and is available at the following link: https://cks.nice.org.uk/topics/blackouts-syncope/diagnosis/assessment/ Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their population. The Government expects ICBs to take account of NICE guidelines and other best practice in designing their local services.

What steps his Department is taking to tackle disparities in length of periods of poor health between (a) people in Somerset and (b) the national average.

The United Kingdom faces significant health inequalities, with life expectancy varying widely across and within communities. The Government is committed to building a fairer Britain by tackling the structural inequalities that contribute to poor health, particularly for disadvantaged groups.The population health priorities in the South West focus on improving population health outcomes and reducing health inequalities and health disparities for inclusion groups. This includes increasing the detection and treatment of people with hypertension, improving the uptake of health checks, increasing the number of people supported to stop smoking, improving the support to people at risk of self-harming, and increasing the number of people affected by long term sickness who are supported back into employment.The Somerset local authority received £23.1 million in Public Health Grant funding in 2024/25. This provides services such as stop smoking, drug and alcohol treatment, health visiting and school nursing, sexual health, and NHS Health Checks among others, all of which contribute to addressing health inequalities.In the South West region, assurance and support for inequalities and inclusion is led by the regional health inequalities team, who work as a blended team across both NHS England and the Office for Health Improvement and Disparities, and who collaborate with national and integrated care system colleagues, including the Directors of Public Health within the region. The health inequalities team supports systems to accelerate the narrowing of gaps in population health outcomes relating to specific South West priorities, and supports the national Core20PLUS5 approach and the implementation of the digital inclusion framework.

What his planned timetable is to introduce early diagnosis services for osteoporosis.

On 6 January 2025, NHS England published the new Elective Reform Plan, which sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament. Further information on the Elective Reform Plan is available at the following link:https://www.england.nhs.uk/publication/reforming-elective-care-for-patients/Part of the plan sets out funding to boost bone density scanning capacity, to support improvements in early diagnosis and bone health conditions such as osteoporosis. This will provide an estimated 29,000 extra scans per year.As announced in the Get Britain Working white paper, we are delivering the joint Department for Work and Pensions, Department of Health and Social Care, and NHS England Getting It Right First-Time (GIRFT) Musculoskeletal (MSK) Community Delivery Programme. With a £3.5 million funding boost, GIRFT teams will deploy their proven Further Faster model to work with integrated care board leaders to further reduce MSK community waiting times, including for those with osteoporosis, and improve data, metrics, and referral pathways to wider support services.

What assessment he has made of the adequacy of the support for out of hours doctors services in (a) Tiverton and Minehead constituency and (b) England.

No such assessment has been made by the Department. The commissioning of out of hours services, and to what extent those services are supported, is the responsibility of local commissioners in partnership with their providers, and in the best interest of their populations.

If he will make an assessment of the adequacy of funding for research into epilepsy.

The Department funds research into epilepsy via the National Institute for Health and Care Research (NIHR). There are currently no plans to assess the adequacy of funding for research into epilepsy, however, the NIHR continues to welcome high quality applications for research into any aspect of human health and care, including prevention, management, and treatment of epilepsy and the related conditions.These 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 the public and health and care services, value for money, and scientific quality. Welcoming applications on epilepsy to all NIHR programmes enables maximum flexibility, both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.The NIHR committed £31.5 million of funding to 28 epilepsy research projects in the five years from April 2019 to March 2024. Additionally, over this period, more than 5,000 people were enabled to participate in epilepsy research by the NIHR Clinical Research Network, now the NIHR Research Delivery Network.The NIHR also works closely with other Government funders, including UK Research and Innovation, which is funded by the Department for Science, Innovation and Technology and includes the Medical Research Council, to fund research into epilepsy to improve treatments and prevent poor health outcomes for patients.

If his Department will make an assessment of the adequacy of funding levels for NHS Dentists in the South West of England; and if his Department will draw up plans on how to use additional funding for the NHS as announced in the Autumn Budget 2024 to provide more dental appointments in the South West of England.

A budget of £3.8 billion for primary, community, and secondary dentistry has been allocated to the integrated care boards (ICBs) across England for 2024/25, to deliver new initiatives and address the challenges facing National Health Service dentistry. Allocations for 2025/26 will be confirmed shortly, and long-term funding will be considered during phase 2 of the Spending Review, which will set budgets for 2026/27 to 2028/29.The Government plans to tackle the challenges patients face when trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments, and recruit new dentists to the areas that need them most.Responsibility for commissioning primary care dentistry to meet the needs of the local population has been delegated to the ICBs across England. For the Tiverton and Minehead constituency, this is the NHS Somerset ICB.

Whether his Department plans to implement the recommendations within the Blood Cancer UK report entitled, UK Blood Cancer Action Plan, published on 4 September 2024.

I refer the Hon. Member to the answer I gave to the Hon. Member for Poole on 11 October 2024 to Question 7389.

Whether he has had recent discussions with adult social care providers on the planned level of funding for the (a) NHS and (b) social care in the next four financial years.

The Department holds regular meetings with adult social care stakeholders, including service providers and representative bodies, to discuss key issues and developments, such as the impact of the Budget on the sector.

If his Department will make an assessment of the adequacy of public funding for Devon Hospiccare in Exeter.

Palliative care services are included in the list of services that the integrated care boards (ICBs) in England, including the NHS Devon ICB, under which Devon Hospiscare falls, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices like Devon Hospiscare, also play in providing support to people at end of life, and their loved ones.We do understand that, financially, times are difficult for many voluntary and charitable organisations, including hospices, due to a range of concurrent cost pressures. We will consider next steps on palliative and end of life care, including funding, in the coming months.

If he will make an assessment of the potential merits of further regulating social care micro-providers.

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. The CQC has powers under the Health and Care Act 2008 to regulate adult social care services, to make sure they provide safe, effective, compassionate, and high-quality care. Where concerns on quality or safety are identified, the CQC uses the regulatory and enforcement powers it has available, and will take action to ensure the safety of people drawing on care and support. Providers of any size are required to be registered with, and therefore regulated by, the CQC, when they carry out personal care for people who are unable to provide it for themselves because of old age, illness, or disability, as defined in Regulation 2 (Interpretation) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). Any amendments to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 would be subject to the usual Parliamentary process, which would include a public consultation, and thus an opportunity to consider the merits of further regulation of social care providers.