Written questions by Gilmour.

How many people have been reported missing from (a) hospitals and (b) other health care settings in each of the last four years for which data is available.

The following table shows a count of patient safety incidents, reported as occurring where the incident category is absconder or missing patient, broken down by care setting, each year from 2020/21 to 2023/24:Care setting of occurrence2020/212021/222022/232023/24Acute or general hospital13,79215,54117,54513,911Ambulance service7664143141Community and general dental service613611Community nursing, medical and therapy service, including community hospital814745801309Community optometry or optician service812952840Community pharmacy0181General practice83917Learning disabilities service14316414394Mental health service10,65411,39613,2817,146Total25,57428,22232,27521,620Source: National Reporting and Learning System, NHS England.Notes:an absconder or missing patient is not a direct equivalent of ‘reported missing’ as it includes issues such as leaving without signing a discharge against medical advice form, or failing to return from agreed leave on time, rather than consisting solely of reports of patients who abscond or who are reported missing to the police.the data also includes reports of patients who are missing from a follow-up, for instance, those who should have been asked to return to a clinic for review but whose call back for a further appointment has been missed.

What plans his Department has for the role hospices will play in shifting care into the community.

We have committed to develop a 10-Year Health Plan to deliver an National Health Service fit for the future, by driving three shifts in the way health care is delivered. We will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders as we develop the plan.One of the three shifts that the plan will deliver is around the Government’s determination to shift more healthcare out of hospitals and into the community. This includes our commitment to trial neighbourhood health centres, to ensure that patients receive personalised care in the most appropriate setting. Palliative and end of life care services, including hospices, will play an important role in our considerations of the services those centres should host. More information about how they can input into the 10-Year Health Plan is available at the following link:https://change.nhs.uk/en-GB/

What steps his Department is taking to (a) increase funding for epilepsy research and (b) improve treatment options for patients with epilepsy.

The Department funds research into epilepsy via the National Institute for Health and Care Research (NIHR). The NIHR spent almost £19 million on 46 epilepsy research projects in the five years from April 2019 to March 2024. Additionally, over this period, more than 9,500 people were enabled to participate in epilepsy research by the NIHR Clinical Research Network, now the NIHR Research Delivery Network.The NIHR welcomes funding applications for research into any aspect of human health, including epilepsy. 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 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.We want a society where every person, including those with long-term conditions such as epilepsy, receives high-quality, compassionate continuity of care, with their families and carers supported. We will change the National Health Service so that it becomes not just a sickness service, but one that is able to prevent ill health in the first place. This will help us be better prepared for the change in the nature of disease, and allow our services to focus more on the management of chronic, long-term conditions, including epilepsy.At the national level, there are a number of initiatives supporting service improvement and better care for patients with epilepsy, including the RightCare Epilepsy Toolkit and the Getting It Right First Time Programme for Neurology, with further information on both available, respectively, at the following two links:https://gettingitrightfirsttime.co.uk/academy-resources/population-health/https://gettingitrightfirsttime.co.uk/medical_specialties/neurology/NHS England has also established a Neurology Service Transformation Programme, a multi-year, clinically led programme to develop a new model of integrated care for neurology services, including for epilepsy.

Whether he plans to roll out NHS-funded Hybrid Close Loop technology to all Type 1 Diabetics in the UK.

In December 2023, the National Institute for Health and Care Excellence published the Technology Appraisal guidance, and recommended that the National Health Service in England makes Hybrid Closed Loop (HCL) systems available to eligible adults, and all children and young people, those under 19 years old, with type 1 diabetes. The NICE and NHS England agreed on a phased implementation period for HCL over five-years, and without the usual 90-day funding mandate. This is because of a need to build essential workforce competencies within specialist adult services. The NHS England HCL Implementation Strategy, published in January 2024, set out how local systems can meet the needs of the eligible population living with type 1 diabetes. The initial phase of the roll out of HCL systems started earlier this year, in April 2024. Further information on the HCL Implementation Strategy is available at the following link:https://www.england.nhs.uk/long-read/hybrid-closed-loop-technologies-5-year-implementation-strategy/

What assessment he has made of the potential impact of the introduction of the National Care Institute for Health and Care Excellence severity modifier in 2022 on the (a) appraisal of Enhertu for HER2-low secondary breast cancer and (b) availability of new treatments for secondary breast cancer over the next (i) five, (ii) ten and (iii) twenty years.

The National Institute for Health and Care Excellence (NICE) is responsible for developing the methods and processes it uses in its evaluations independently, and in consultation with stakeholders. The severity modifier that the NICE introduced in 2022 is based on evidence of societal preferences, and was introduced as part of a comprehensive review of the NICE’s methods and processes, following extensive public and stakeholder engagement. The severity modifier was designed to be opportunity cost neutral in relation to the end of life modifier that it replaced, and to apply to a broader range of conditions than had benefited from the end of life modifier.The NICE was unfortunately unable to recommend Enhertu (trastuzumab deruxtecan) for the treatment of HER2-low secondary breast cancer in its final guidance published in July 2024, despite the topic being awarded a severity weighting. Other drugs for advanced cancer, including breast cancer, have been approved using these methods.No assessment has been made on the likely impact on appraisals of future breast cancer medicines. However, since its introduction, the severity modifier has resulted in a higher approval rate for cancer medicines than under the NICE’s previous methods, and has also allowed greater weight to be applied to non-cancer medicines that address a broader range of severe diseases, enabling the NICE to recommend medicines for conditions such as cystic fibrosis and hepatitis D. The NICE is keeping the impact of the severity modifier under review and is scoping further research into society’s preferences on how much additional weighting to give to health benefits for people with severe diseases.