Written questions by Tice.

If he will undertake a review of eligibility criteria for non-emergency patient transport services; and if he will make it his policy to expand eligibility to include transport of patients receiving haemodialysis to dialysis or transplant assessment and follow-up appointments when those services are not commissioned locally.

Non-Emergency Patient Transport Schemes (NEPTS) often provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.  NEPTS can be provided by ambulance trusts or other providers depending on local arrangements.In May 2022, NHS England set out eligibility criteria, which includes disability criteria, available at the following link:https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdfNHS England has worked closely with a range of kidney patient groups, renal professionals, integrated care boards (ICBs), and other stakeholders to develop a dialysis transport support framework which has been made directly available to ICBs. The 2022 updates to the eligibility criteria included where patients are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport, or upfront/reimbursement costs for private travel will be made available.NEPTS in England is an operational matter for the National Health Service, and how the NEPTS guidance is implemented at a local level is determined by ICBs and their partners, including local ambulance trusts. There are no current plans to update the eligibility criteria further.

What assessment his Department has made of the potential impact of Non-Emergency Patient Transport Services eligibility criteria on access to transplant services for patients with chronic kidney disease required to travel outside local Integrated Care Board areas.

Non-Emergency Patient Transport Schemes (NEPTS) often provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.  NEPTS can be provided by ambulance trusts or other providers depending on local arrangements.In May 2022, NHS England set out eligibility criteria, which includes disability criteria, available at the following link:https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdfNHS England has worked closely with a range of kidney patient groups, renal professionals, integrated care boards (ICBs), and other stakeholders to develop a dialysis transport support framework which has been made directly available to ICBs. The 2022 updates to the eligibility criteria included where patients are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport, or upfront/reimbursement costs for private travel will be made available.NEPTS in England is an operational matter for the National Health Service, and how the NEPTS guidance is implemented at a local level is determined by ICBs and their partners, including local ambulance trusts. There are no current plans to update the eligibility criteria further.

What the average wait time is for an NHS ambulance response to a Category 1 emergency in (a) Boston and Skegness constituency and (b) the UK.

The Boston and Skegness constituency is served by the East Midlands Ambulance Service NHS Trust (EMAS). The latest National Health Service figures show that in December 2025, the average Category 1 response time in EMAS was nine minutes 12 seconds. This compares to the national average of seven minutes 59 seconds.Through our Urgent and Emergency Care Plan for 2025/26, we are taking action to improve ambulance response times across England, including in Lincolnshire. The plan commits to reducing average response times for Category 2 incidents to 30 minutes this year. Supported by almost £450 million of capital investment, we are expanding same-day and urgent care capacity, delivering 500 new ambulances, and enhancing the speed and quality of care for the most seriously ill and injured patients. We are also tackling unacceptable ambulance handover delays by introducing a maximum 45-minute standard, supporting ambulances to be released more quickly and get back on the road to treat patients.

With reference to the oral contribution of the Minister for Care during the Adjournment debate on 20 March 2025, Official Report, column 610, what steps his Department has taken to ensure that all patients are offered face-to-face appointments when one is requested (a) in Boston and Skegness constituency and (b) England; how many face-to-face GP appointments have there been in each of the last 12 months; and how these figures compare with pre-COVID-19 levels.

We recognise the significant value of face-to-face appointments. That is why the Government has guaranteed a face-to-face appointment for all those who want one, both nationally and in Boston and Skegness. We have invested an extra £1.1 billion into primary care, recruited an extra 2,500 general practitioners (GPs), resulting in 6.5 million more GP appointments delivered to patients, than in the previous year. Our continued investment is designed to enhance access to all GP appointments, irrespective of their mode, enabling patients to choose either face-to-face or remote consultations in line with their preferences and clinical needs. The National Health Service is clear that GPs must provide face-to-face appointments, alongside remote consultations, and patients’ input into consultation type should be sought and their preferences for face-to-face care respected unless there are good clinical reasons to the contrary. Face-to-face GP appointments in Boston and Skegness are up 7.5% since before COVID-19, rising from 569,000 in 2019 to 612,000 in 2025. Nationally, face-to-face GP appointments dropped by 1.3%, from 241 million in 2019 to 238.6 million in 2025.

What the annual cost to the NHS is of providing healthcare to illegal migrants.

The Department of Health and Social Care and NHS England do not hold the information requested. The overall management of asylum seekers is a matter for the Home Office.

With reference to the Patient Safety Commissioner's report entitled The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh, published on 7 February 2024, what estimate his Department has made of (a) the number of families affected, (b) the total cost of interim payments and (c) the projected cost of a main payment and care plan as outlined in that report; and if he will publish his Department’s analysis of those figures.

The Government is carefully considering the work by the Patient Safety Commissioner and her Report, which set out options for redress for those harmed by valproate and pelvic mesh. This is a complex issue involving input from different government departments. The Government will provide a further update to the Patient Safety Commissioner’s Report.

What steps his Department is taking to ensure continuity of community equipment services following the insolvency and receivership of NRS Healthcare; and what plans are in place to minimise disruption to patients reliant on (a) wheelchairs, (b) mobility aids, (c) hospital beds and (d) other essential medical equipment to prevent impact on (i) hospital discharge and (ii) independent living.

We recognise and share your concerns around ensuring the continuity of community equipment services following the insolvency of NRS Healthcare.Community equipment services are vital. The Partners in Care and Health programme, funded by the Government, has been working closely with local authorities to support continued service provision following the insolvency of NRS Healthcare. Local authorities have a statutory duty under various pieces of legislation, including the Care Act 2014 and the Children and Families Act 2014, to ensure the provision of disability aids and community equipment, to meet the assessed eligible needs of individuals who are resident in their area.

What steps his Department is taking to help ensure that the forthcoming National Cancer Plan for England includes targeted measures to improve the early diagnosis of (a) myeloma and (b) other blood cancers.

It is a priority for the Government to support the National Health Service to diagnose cancer, including blood cancers such as myeloma, as well as other unstageable cancers, as early and quickly as possible, and to treat it faster, in order to improve outcomes.To tackle late diagnoses of blood cancers, the NHS is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.We will get the NHS diagnosing blood cancer earlier and treating it faster, and we will support the NHS to increase capacity to meet the demand for diagnostic services through investment, including for magnetic resonance imaging and computed tomography scanners.The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.

With reference to the report by Sands entitled Lost in the system, published in July 2025, what steps his Department is taking to ensure equitable access across England to specialist psychological support services for parents who experience pregnancy or baby loss.

Experiencing pregnancy or baby loss can be extremely difficult and traumatic. The Government is determined to make sure all bereaved parents, regardless of where they live, have access to specialist psychological support.As of June 2025, Maternal Mental Health Services are now available in all areas of England. These services provide specialist psychological support for women with moderate/severe or complex mental health difficulties arising from birth trauma or baby loss.All trusts in England are also signed up to the National Bereavement Care Pathway. This pathway is designed to improve the quality and consistency of bereavement care for parents and families experiencing pregnancy or baby loss.We also recognise the importance of maternity bereavement services being available at all times. ‘7 days a week’ bereavement services are in the process of being set up in every area in England to support women and families who experience pregnancy loss or neonatal death.

What assessment he has made of the potential implications for his policies of reports that patients at Pilgrim Hospital outpatients department are being left for extended periods without access to beds due to lack of bed availability; and what steps he is taking to ensure timely access to inpatient care in Lincolnshire.

The Government is clear that patients should expect and receive the highest standard of care and accepts that urgent and emergency care performance has been below the high standards that patients should expect in recent years. Providing care in corridors, and other inappropriate settings, is completely unacceptable.Our Urgent and Emergency Care Plan, published in June 2025, set out the steps we are taking to ensure at least 78% of patients in A&E departments are seen within four hours, to reduce the number of patients waiting over 12 hours for admission or discharge from an emergency department, and to reduce ambulance handover times to a maximum of 45 minutes.NHS England has been working with trusts to put in place new reporting arrangements related to the use of temporary escalation spaces, to drive improvement. Subject to a review of data quality, this information will be published shortly, and we will consider how this data could be published on a more regular basis.

What steps his Department is taking to help ensure that (a) NHS Lincolnshire and (b) other Integrated Care Boards implement the NICE Fertility Guideline recommending (i) three full cycles of IVF for eligible women under 40 and (ii) one full cycle for women aged 40 to 42; and if he will take steps to improve access to NHS-funded fertility treatment.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to improve NHS-funded fertility services.We expect integrated care boards (ICBs) to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines, ensuring equal access to fertility treatment across England.NICE is currently reviewing the fertility guidelines and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. A consultation on revised guidelines was published on 10 September.In light of broader pressures on the National Health Service and on on-going changes within NHS England, we have been looking again at achievable ambitions to improve access to fertility services and fairness for all affected couples.

With reference to the report by Sands entitled Lost in the system: Saving babies’ lives, published on 10 July 2025, what steps his Department is taking to ensure that bereaved parents who have experienced pregnancy or baby loss have the same level of access to specialist psychological support in each postcode.

Experiencing pregnancy or baby loss can be extremely difficult and traumatic. We are determined to make sure that all bereaved parents, regardless of where they live, have access to specialist psychological support.As of June 2025, Maternal Mental Health Services are now available in all areas of England. These services provide specialist psychological support for women with moderate/severe or complex mental health difficulties arising from birth trauma or baby loss.All trusts in England are also signed up to the National Bereavement Care Pathway. This pathway is designed to improve the quality and consistency of bereavement care for parents and families experiencing pregnancy or baby loss.We also recognise the importance of maternity bereavement services being available at all times. Seven day a week bereavement services are in the process of being set up in every area in England to support women and families who experience pregnancy loss or neonatal death.

What steps his Department is taking to increase the number of consultants in (a) Lincolnshire NHS Trust and (b) other (i) rural and (ii) semi-rural areas; and if he will review (A) funding allocations and (B) workforce planning to ensure urgent cases are seen in a clinically appropriate timeframe.

We will publish a 10 Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible, and more fulfilled. We will ensure the National Health Service has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.Doctors are more likely to settle and practice in the areas they train. We will work with the university and college sector to ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities, including in rural and semi-rural areas such as Lincolnshire.NHS England regularly keeps its funding allocations under review, and as set out in our recently published 10-Year Health Plan, we will break the old, short-term cycle of planning, and will ask all organisations to prepare robust and realistic five-year plans. Every organisation will be required to continue to refresh their plans over the medium term.Decisions about recruitment in individual NHS trusts are a matter for those trusts, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.

Whether his Department has made an assessment of the adequacy of access to spinal services for patients in Boston and Skegness constituency; and what steps he is taking to ensure that residents can access (a) timely and (b) geographically appropriate spinal care.

The local acute trust in Lincolnshire, United Lincolnshire Teaching Hospitals NHS Trust (ULTH), does not have a spinal service. Emergency services take non-complex patients with potential spinal issues to the closest accident and emergency within Lincolnshire to be treated or stabilised, but if the patient is assessed at scene as having a spinal injury they will be transported directly to the Tertiary Centre at Nottingham University Hospital (NUH). NUH also provides a spinal consultant who supports ULTH on a weekly basis.General practitioners in the Skegness and Boston area can refer patients to a local spinal assessment service which completes a full assessment of the patient’s condition with appropriate diagnostics. There are then two pathways for spinal services based on clinical need. Non-complex patients will be offered choice of local acute services and complex patients are offered a choice of the tertiary centres at NUH & Sheffield.NHS England’s Midlands Regional Team has developed and implemented a network model of care for spinal cord injury (SCI) patients. Specialist clinicians in SCI provide acute care, intervention and training including outreach to local hospitals for patients who need SCI rehabilitation whilst they are waiting for a bed at a specialist SCI centre. SCI rehabilitation for Lincolnshire patients is primarily delivered via the specialist SCI centre in Sheffield. For Lincolnshire, NHS England has recognised that there is a significant clinical gap in these patients being managed locally whilst waiting for a specialist SCI rehabilitation bed. NHS England has allocated funding as part of the Network Model of Care for a post to be based at Lincoln Country Hospital to provide specialist support for Lincolnshire residents. Currently, this post is vacant, but NHS England and the trust are working towards successful recruitment.

Whether NHS England supports the policy of excluding children from community health services on the basis of school type; and what assessment he has made of the merits of such a policy.

There is no policy that excludes children from community health services on the basis of school type. The National Health Service is free at the point of use and provides care to anyone who need it based on clinical need. NHS occupational therapy services are provided for all children with an education, health and care plan (EHCP). For those without an EHCP, some schools provide on-site NHS occupational therapy.

What assessment his Department has made of the adequacy of the (a) availability and (b) timeliness of end-of-life palliative care support in Boston and Skegness constituency; and what steps he is taking to ensure that terminally ill patients fast-tracked due to a prognosis of fewer than 12 weeks to live receive appropriate physical and social care at home without having to wait until their final four weeks of life.

Palliative care services are included in the list of services an integrated care board (ICB) must commission, including Lincolnshire ICB, which covers the Boston and Skegness constituency. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations.To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance requires ICBs to work to ensure that there is sufficient provision of palliative and end of life care services to meet the needs of their local populations.Additionally, the Lincolnshire ICB area benefits from a single palliative point of access that operates 24 hours a day, seven days a week: a single phone number, facilitated by specialist palliative nurses and the urgent and emergency care clinical assessment service, through which patients, families, carers and professionals can access care that is co-ordinated and delivered locally.NHS Continuing Healthcare (CHC) is a package of National Health Service-funded ongoing health and social care for adults with the highest levels of complex, intense or unpredictable needs that have arisen as a result of disability, accident or illness.Lincolnshire ICB’s policy for fast-track CHC funding does not set out a timeframe for applications based on the number of weeks of prognosis, but it is based on the narrative within the National Framework for NHS CHC of “rapidly deteriorating and entering end phase of life”. The CHC team works seven days a week to ensure fast-track applications are processed in a timely manner.There is a dedicated CHC End of Life Case Manager for Boston and Skegness, who ensures people’s packages of care are appropriate and meeting the needs of the individual throughout their time they are in receipt of fast-track funding. Lincolnshire ICB has a contract in place with a single provider for Boston and Skegness, which ensures packages of care are arranged and delivered in a timely manner.

What steps his Department is taking to ensure that qualified (a) counsellors and (b) psychotherapists are (i) supported and (ii) distinguished from (A) psychiatric and (B) diagnostic services.

It is essential that all National Health Service staff, including counsellors and psychotherapists, can work in a supportive and compassionate environment that recognises and prioritises health and wellbeing. NHS England has a wide-ranging package of mental health and wellbeing support for all staff.All healthcare professionals should follow the National Institute for Health and Care Excellence guidelines, which state that healthcare professionals directly involved in a patient's care should introduce themselves and explain their role to the patient.Counsellors and psychotherapists are not statutorily regulated in the United Kingdom. Health professionals that are not subject to statutory regulation can join voluntary registers accredited by the Professional Standards Authority for Health and Social Care (PSA), such as the UK Council for Psychotherapy and the British Association for Counselling and Psychotherapy, who also provide support to their members.The organisations accredited by the PSA are independent, representative bodies and as such, they do not fall under Government oversight, and therefore any decisions about the practice requirements for the professions they represent are a matter for those organisations and their members.

What steps the Department is taking to (a) improve value for money, (b) prevent profiteering, (c) remove conflicts of interest in referral practices and (d) otherwise improve (i) oversight and (ii) regulation of private companies delivering NHS-funded eye care.

All National Health Service patients must receive safe and high-quality care, whether being treated by private providers or directly by the NHS. While the independent sector has a role to play in tackling the waiting list backlog, we will not tolerate any overpriced or sub-par care. We will also not tolerate any distortion of patient choice, and the recently published Partnership Agreement between NHS England and the Independent Healthcare Providers Network commits to ending incentives that can lead to this, supporting equal access and genuine choice for all patients. We are now working together to deliver on this.Improving value for money is a priority across all NHS pathways, not just in eyecare. This has been emphasised in various documents such as the Provider Selection Regime, the NHS Standard Contract and most importantly the Independent Sector Agreement, published in January 2025.NHS-funded eye care is funded based on national prices and funded equitably across all providers with no opportunities to gain increased payment; prices are adjusted each year to reflect expected improvements in efficiency and are set to cover costs but not margins.To prevent profiteering, providers are paid based on national prices, based in turn on the average cost of providing the service and adjusted to reflect the complexity of the procedure and the patient. This ensures that the provider is appropriately reimbursed, and they do not make excess profits by targeting the simplest cases.NHS England expects all its providers to support patient choice and to act in accordance with the Law, with Good Practice and this is supported by the requirements of the NHS Standard Contract, the NHS Provider License, the General Ophthalmic Services contract and the Law itself. The NHS Standard Contract gives a useful overview of the Provider Selection Regime, which are the regulations the NHS must adhere to when commissioning health care services, including conflict of interest declarations.Finally, private companies are commissioned and managed by integrated care boards under the terms of the NHS Standard Contract which applies the same standards of oversight and regulation as are applied to NHS providers.

Whether her Department is taking steps to review the Medical Certificate of Cause of Death process to speed up that process in (a) Boston and Skegness constituency and (b) the UK.

The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024, through the Death Certification Strategic Board and a cross-Government data strategy group. Since the introduction of the reforms, the median time taken to register a death appears to have risen by two days, from seven days to nine days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. Working with the Office for National Statistics, weekly data is now published on the time taken to register a death by region and also by setting. This is supporting NHS England and the Welsh administration to offer support and challenges.The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.The introduction of medical examiners is in part about making sure deaths are properly described and improving practice, but the impact on the bereaved is also central. The reforms aim to put the bereaved at the centre of the process, and the medical examiner’s office must offer a conversation with representatives of the deceased, so they can ask any questions they have about the death or raise any concerns. Ensuring the system is appropriately resourced and works for all those who interact with it is crucial, and something we will continue to monitor with NHS England.

What assessment he has made of the reasons for delays in emergency service response times in Boston and Skegness constituency; and what steps are being taken to improve response times.

Ambulance services in Boston and Skegness are provided by the East Midlands Ambulance Service NHS Trust, with responsibility for commissioning the services a matter for the local Lincolnshire Integrated Care Board. Any assessment of the specific local actions needed to improve response times should be undertaken and agreed locally by National Health Service organisations in the best interests of the local population and patients.At a national level, the Government and NHS England are committed to improving ambulance response times. The NHS 2025/26 priorities and operational planning guidance sets national priorities, which include improving accident and emergency waiting times and ambulance response times compared to 2024/25.