Written questions by Savage.

How he is balancing rapid access targets with preserving continuity, especially for patients with long-term or complex conditions.

The Government values continuity in general practice (GP), but this isn't inconsistent with efforts to improve access, such as via the 24-hour access target where urgent treatment is required.In the 2025/26 contract, one of the domains of the Capacity and Access Improvement Payment, worth £29.2 million, incentivises primary care networks to risk stratify their patients to support continuity of care, including patients with long-term or complex conditions. This allows GPs to deliver care to meet the specific needs of their patients Over the past 16 months, the Government has invested an extra £1.1 billion into primary care, allowing for the recruitment of over 2,000 more GPs, and has halved the number of targets GPs are held to so that GPs can spend more time caring for patients. As a result, patient satisfaction with GPs has improved after a decade of decline, rising from 61% in July 2024 to 74% in July 2025, marking a 13-percentage-point increase over the last year.Over ten million more GP appointments have been delivered in the 12 months to September 2025, compared to the same period last year, building capacity for continuity of care and improving access so that patients can be seen when they need to be in primary care.We have always valued input from a range of stakeholders on the future of GPs and continue to engage with GPs broadly to ensure the targets are achievable, reflect the needs of the populations they serve, and understand any barriers to delivery of this target.

If he will review access metrics to ensure that they support relationship-based care in general practice.

The Government values continuity in general practice (GP), but this isn't inconsistent with efforts to improve access, such as via the 24-hour access target where urgent treatment is required.In the 2025/26 contract, one of the domains of the Capacity and Access Improvement Payment, worth £29.2 million, incentivises primary care networks to risk stratify their patients to support continuity of care, including patients with long-term or complex conditions. This allows GPs to deliver care to meet the specific needs of their patients Over the past 16 months, the Government has invested an extra £1.1 billion into primary care, allowing for the recruitment of over 2,000 more GPs, and has halved the number of targets GPs are held to so that GPs can spend more time caring for patients. As a result, patient satisfaction with GPs has improved after a decade of decline, rising from 61% in July 2024 to 74% in July 2025, marking a 13-percentage-point increase over the last year.Over ten million more GP appointments have been delivered in the 12 months to September 2025, compared to the same period last year, building capacity for continuity of care and improving access so that patients can be seen when they need to be in primary care.We have always valued input from a range of stakeholders on the future of GPs and continue to engage with GPs broadly to ensure the targets are achievable, reflect the needs of the populations they serve, and understand any barriers to delivery of this target.

What steps he is taking to support Cirencester Hospital.

Decisions about NHS services, including in Cirencester, are best taken at a local level, and the responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate NHS commissioner. All service changes should be based on clear evidence that they will deliver better outcomes for patients. Substantial planned service change should be subject to a full public consultation and meet the Government and NHS England’s ‘tests’ to ensure good decision-making.The Department does not hold information centrally on the number of services that have been permanently decommissioned from community hospitals following temporary trials.

What information his Department holds on the number of services that have been permanently cut from community hospitals following temporary trials in each year for which information is available.

Decisions about NHS services, including in Cirencester, are best taken at a local level, and the responsibility for the delivery, implementation and funding decisions for services ultimately rests with the appropriate NHS commissioner. All service changes should be based on clear evidence that they will deliver better outcomes for patients. Substantial planned service change should be subject to a full public consultation and meet the Government and NHS England’s ‘tests’ to ensure good decision-making.The Department does not hold information centrally on the number of services that have been permanently decommissioned from community hospitals following temporary trials.

Whether he will commit extra funding for social prescribing, including to support individuals to engage in nature-based interventions and activities.

The Government has underlined its commitment to taking a preventive approach to address health inequalities.  We are determined to improve people’s physical and mental health to support them to live longer and healthier lives and we recognise the role that social prescribing can play in this.The Department funds social prescribing link workers in primary care through the Additional Roles Reimbursement Scheme.  In March 2025, the Department agreed a further year of grant funding for the National Academy for Social Prescribing, securing £1.5 million to advance and expand social prescribing.  Future funding allocations have yet to be confirmed.The Department for Environment, Food and Rural Affairs leads on green social prescribing and, together with Natural England, has recently invested £300,000 to track the uptake and impact of green social prescribing using primary care data. The evidence will inform future policy for the spread and scale of nature-based health interventions.

What recent assessment he has made of the potential impact of the cost of residential and nursing care home fees on older people; and if his Department will take steps to ensure that annual fee increases are transparent.

Fee rates are set by the providers of adult social care, the majority of which are in the independent sector. The Department does not have the power to limit the level of fees that a care home can charge. However, all businesses are required to comply with the Consumer Rights Act 2015 by ensuring that they use fair and clear terms in their standard agreements with customers.The importance of price transparency is set out in Regulation 19 of the Care Quality Commission (Registration) Regulations 2009, which requires that providers give timely and accurate written information about the cost of their care and treatment to the people who use their services.

What steps his Department is taking to support families with rises in care home fees for relatives with dementia; and whether he has made an assessment of the impact of those changes on the savings of older people.

The Department does not hold data on self-funder residential care home fees sufficient to make a comparative assessment between different local authorities. Fee rates are set by providers of adult social care. The Department does not have the power to limit the level of fees that a care home can charge. However, all businesses are required to comply with the Consumer Rights Act 2015 by ensuring that they use fair and clear terms in their standard agreements with customers.We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will deliver recommendations for the transformation of adult social care, including how to best create a fair and affordable adult social care system.The current system of charging for care provides funded support for those with the least financial means. Only the income and assets, including savings, of the cared for individual can be considered by the local authority when assessing their financial eligibility for support. Where individuals have assets below £14,250, they will not contribute to their care from their assets. Local authorities have the power to set a higher threshold if they choose.

If he will make a comparative assessment of the level of the residential care home fees (a) in England, (b) Wiltshire and (c) Gloucestershire; and what steps his Department is taking to ensure (i) care home residents and (ii) the families of care home residents are protected from above-inflation increases in care charges.

The Department does not hold data on self-funder residential care home fees sufficient to make a comparative assessment between different local authorities. Fee rates are set by providers of adult social care. The Department does not have the power to limit the level of fees that a care home can charge. However, all businesses are required to comply with the Consumer Rights Act 2015 by ensuring that they use fair and clear terms in their standard agreements with customers.We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will deliver recommendations for the transformation of adult social care, including how to best create a fair and affordable adult social care system.The current system of charging for care provides funded support for those with the least financial means. Only the income and assets, including savings, of the cared for individual can be considered by the local authority when assessing their financial eligibility for support. Where individuals have assets below £14,250, they will not contribute to their care from their assets. Local authorities have the power to set a higher threshold if they choose.

Whether his Department is taking to (a) improve food allergy safety and (b) provide safe gluten-free options in the hospitality sector through (i) enforcing standards on the prevention of cross-contamination, (ii) reducing reliance on generic allergy disclaimers, (iii) supporting small businesses with access to gluten-free ingredients and staff training and (iv) encouraging the uptake of accreditation schemes to ensure that people with coeliac disease and other food allergies can dine out safely.

The Food Standards Agency (FSA) is the independent Government department responsible for food safety and allergen labelling in England, Wales, and Northern Ireland. Food business operators (FBOs) need to tell customers if any food they provide contains any of the 14 listed allergens as an ingredient, including cereals containing gluten. Further information on the allergen guidance for food businesses and the food allergen labelling and information requirements is available, respectively, at the following two links: https://www.food.gov.uk/business-guidance/allergen-guidance-for-food-businesses https://www.food.gov.uk/business-guidance/food-allergen-labelling-and-information-requirements-technical-guidance-introduction In March 2025, the FSA published new guidance, Allergen Information for Non-Prepacked Foods Best Practice, which recommends that allergen information be provided in writing, and supported by a conversation with the consumer. We have also emphasised the need for those with allergies to mention these when ordering food. This new guidance is available at the following link: https://www.food.gov.uk/business-guidance/allergen-information-for-non-prepacked-foods-best-practice-introduction All food businesses must have a food safety management system based on the Hazard Analysis Critical Control Point principles. This includes identifying hazards including allergens, determining critical control points, setting limits, monitoring, corrective actions, verification, and record-keeping. Businesses can use ‘gluten-free’ claims if the level of gluten is 20 milligrams per kilogram or less, and should be able to verify such a claim. The enforcement of hygiene and allergen information regulations is the responsibility of local authorities, who monitor compliance with the latter through the Food Standards Delivery Model.Food law does not oblige FBOs to provide gluten-free food or ingredients. However, if an FBO is made aware of a person’s allergen requirements and has agreed to provide a meal, they have an obligation to ensure that the meal does not contain that allergen and is safe. FBOs must ensure that staff receive training commensurate to their role, and the FSA has provided free online allergen training via their website, at the following link: https://www.food.gov.uk/business-guidance/allergy-training-for-food-businesses This training has been accessed by over 915,000 users, including those in hospitality, to help food businesses to understand the importance of allergies. The FSA also provides guidance to FBOs and trade associations, and to local authorities who are responsible for enforcing allergen labelling laws. As a regulator, the FSA does not provide accreditation or certification and is not in a position to endorse any other accreditation schemes. However, the FSA recognises its role in helping consumers identify safe dining options and encourages businesses to consider such schemes where appropriate.

What discussions he has had with the care sector on the adequacy of safeguarding procedures in private care homes that employ staff recruited from overseas.

Any form of abuse or neglect is unacceptable, and regulated providers have a key role in safeguarding adults. All staff are subject to employer checks and controls, and employers must satisfy themselves regarding the skills and competence of their staff.The Care Quality Commission (CQC) monitors how well providers are safeguarding service users. As part of their regulatory regime, the CQC checks that care providers have effective systems to help keep adults safe from abuse and neglect.International workers applying for a Health and Care Visa must submit a criminal record certificate from any country that they have resided in for 12 months or more in the last ten years. Further to this, a Disclosure and Barring Service check must be undertaken.

What steps his Department is taking to ensure that care providers have a (a) clear and (b) enforceable duty of care towards employees who are victims of serious assaults in the workplace.

The Government condemns violent or aggressive behaviour towards social care staff. They have a right to expect a safe and secure workplace.The Health and Safety at Work etc. Act 1974 (HSWA), and the health and safety regulations made under it, impose duties on employers, such as care providers, to ensure, so far as is reasonably practicable, the health, safety, and welfare of their workers, and to assess the risks to employees and take appropriate measures to prevent or reduce the risk. The HSWA applies to work-related acts of violence and aggression. Health and Safety Executive, along with local authorities, play a critical role in preventing violence in the workplace by regulating and enforcing health and safety legislation in Great Britain. Other enforcing authorities, such as the police, are responsible for dealing with the criminal acts of serious assaults and for bringing the perpetrators to justice.

If he will make an assessment of the potential merits of extending the eligibility for free prescriptions to people with Shwachman-Diamond Syndrome.

There are no plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate.There are extensive arrangements in place in England to ensure that prescriptions are affordable for everyone. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with Schwachmann Diamond Syndrome may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme, which provides help based on a comparison between a person’s income and requirements.People who need to pay and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs allow people to claim as many prescriptions as needed for a set cost. An annual PPC costs £114.50 and will save money if they need 12 or more items in 12 months. To help spread the cost, people can pay for an annual PPC by ten monthly direct debits, which works out as just over £2 per week. A three-month PPC for £32.05 is also available.

Whether his Department has made an assessment of the potential impact of constituency boundary changes on the availability of (a) discharge to assess and (b) respite care beds in South Cotswolds constituency; and what steps he is taking to ensure local provision of those beds.

Hospital discharge and respite care planning and provision are the responsibility of local authorities and local National Health Service bodies, including integrated care boards, trusts and foundation trusts. The geographical footprint of these bodies is not affected by constituency boundary changes.

Whether he has made an assessment of the potential impact of the ingestion of microplastics from plastic-based chewing gum on public health.

The Food Standards Agency (FSA) is monitoring and assessing emerging information concerning the wider issue of microplastics in food.The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) is an independent scientific advisory committee that provides advice to the FSA and other Government Departments. No assessment has been made on the potential impact of the ingestion of microplastics from chewing gum specifically, as the COT is currently considering the issue of microplastics in general.The COT has previously concluded that there is currently insufficient data to carry out a full risk assessment. Further research is required into standardisation of analytical techniques as well as the effects of microplastics on humans. The FSA is keeping the issue of microplastics under review as new evidence becomes available.

Whether his Department has made a recent assessment of the potential impact of providing funding for (a) continuous glucose monitoring and (b) other preventive technologies on (i) NHS expenditure and (b) complications arising from type II diabetes.

Data from the National Diabetes Audit suggests that the number of people with type 2 diabetes using continuous glucose monitoring is increasing. In 2022/23, 37,000 people were using continuous glucose monitoring, rising to 95,000 people in 2023/24, and to 155,000 people in 2024/25. Metrics that are useful for health systems to monitor access to glucose monitoring will be published later this year Unlike for medicines, there is no national pathway to prioritise and nationally fund the highest impact health technology, including wearable technology. As a result, we see significant unwarranted variation in uptake, weakening the perceived attractiveness of the United Kingdom’s market. From April 2026, building on and adapting our experience with medicines, we will begin expanding NICE’s technology appraisal process, which includes mandated funding by the NHS, to cover some devices, diagnostics, and digital products. This will focus on those that meet the NHS’ most urgent needs and support financial sustainability.By 2035, all patients will have access to wearables. Wearables will enable patients and their carers to better manage their care by having access to their health data such as blood pressure and glucose levels. They will also enable remote monitoring to alert a patient’s care team to any issues so that appropriate interventions can be made quickly before they progress. The 10-Year Health Plan aims to reduce the prevalence of type 2 diabetes and enhance the care of patients living with diabetes through the delivery of the three shifts:from hospital to community, which will enable those living with diabetes to manage their care in the best way for them through the Neighbourhood Health Service;from analogue to digital, which will make it easier for those living with diabetes to access tailored advice and manage their appointments at a time that suits them; andfrom treatment to prevention, which will make it easier for people to access diabetes screening and support people to make healthier choices to prevent them from developing type 2 diabetes.

What assessment his Department has made of the potential impact of providing free continuous glucose monitoring systems to patients eligible for the NHS Diabetes Prevention Programme; and if he will make an assessment of the potential impact of doing so on (a) the incidence of and (b) complications arising from type II diabetes.

Continuous glucose monitoring systems are available on the National Health Service in line with National Institute for Health and Clinical Excellence guidelines which state that, among other criteria, a person must have a diagnosis of diabetes. People with a diagnosis of diabetes are not eligible for the NHS Diabetes Prevention Programme (NHS DPP).Therefore, no assessment has been made on the impact of providing free continuous glucose monitoring systems through the NHS DPP.

What assessment his Department has made of the potential impact of (a) removing (i) dental therapist and (ii) dental technician roles and (b) other changes to the Skilled Worker visa eligibility list on internationally trained dental professionals seeking registration with the General Dental Council.

Registration with the General Dental Council in the United Kingdom is a separate process from obtaining a Skilled Worker or Health and Care Worker visa, although both are required to enable overseas dental professionals to work in the UK.On 1 July 2025, changes to immigration rules were laid before Parliament which, subject to Parliamentary approval, will come into force from 22 July. Dentists and dental therapists meet the new higher skill level of Regulated Qualifications Framework (RQF) level 6 or above, and continue to remain eligible for the Health and Care Worker visa under the immigration changes.The expanded Immigration Salary List (ISL) and interim Temporary Shortage List (TSL) allow time-limited access, until the end of 2026, to the UK’s immigration system for selected occupations of skill level RQF 3 to 5, with restrictions on bringing dependants. The evidence considered by the independent Migration Advisory Committee for the ISL and by the Department for Business and Trade for the TSL did not support including dental technicians, dental nurses, or dental hygienists on either list. Therefore, these occupations will no longer be eligible for the Health and Care Worker visa or Skilled Worker visa from 22 July. A transition period applies for those already in the UK, where skilled workers can continue to be sponsored in RQF level 3 to 5 occupations if they are already in the route, meaning they have a visa or have a Certificate of Sponsorship issued, before 22 July, even where an occupation is not on the ISL or the TSL, providing they continue to meet all other requirements of the route.

Whether he plans to implement enhanced public awareness campaigns to educate the public on the importance of (a) HPV vaccination and (b) regular cervical screening.

The UK Health Security Agency (UKHSA) works alongside NHS England and the Department to promote the human papillomavirus (HPV) vaccination as part of a national programme to prevent cervical cancers caused by HPV.Throughout the year, UKHSA's data and surveillance is used to create public and stakeholder communications, and to raise awareness of HPV and the importance of the vaccine. UKHSA also publishes and provides a range of supporting materials to health professionals on both the 12- and 13-year-old HPV offer, and the vaccine programme for those at higher risk.The NHS Cervical Screening Programme, through NHS England, has a series of initiatives underway, including developing a digital-first approach.

What steps his Department is taking to implement targeted outreach programmes in areas with low (a) HPV vaccination and (b) cervical screening rates to (i) help tackle health disparities and (ii) ensure equitable access to preventive services.

In March 2025, NHS England published the Cervical cancer elimination plan by 2040 – plan for England, setting out how the National Health Service will improve equitable uptake and coverage across human papillomavirus (HPV) vaccination and cervical screening to meet the goal to eliminate cervical cancer by 2040. Further information on the Cervical cancer elimination plan by 2040 – plan for England is available at the following link: https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/ The plan builds on five cross-cutting themes: - increasing access;- raising awareness;- reducing inequalities;- improving digital capabilities; and- strengthening workforce capacity. NHS England has launched its first ever cervical cancer elimination creative campaign and communications toolkit for Cervical Screening Awareness Week, from 16 to 24 June 2025. The campaign will include digital resources that create a strong sense of shared responsibility and which aim to increase awareness of the elimination goal, educate the public about HPV, and build confidence in the HPV vaccine and cervical screening. There are differences in vaccination and screening coverage between communities, and some groups face inequalities. Health inequalities must continue to be addressed. NHS England will continue: - building their understanding of the barriers to and perceptions of HPV vaccination and cervical screening, and will share this with local systems to support the planning of culturally-sensitive, community-led engagements with low uptake groups;- developing inclusive materials to better reach underserved communities through trusted voices;- identifying groups using national and local level data who may be at higher risk of developing cervical cancer; and- enabling trans men and non-binary people with a cervix to be routinely invited for cervical screening.

What steps he is taking to ensure NHS GP surgeries process private medical paperwork in a timely manner; and whether his Department plans to issue updated guidance to prevent administrative delays that could adversely affect patient outcomes.

We are working across Government to cut red tape and improve ways of working, including work to improve the patient experience, such as streamlining or removing the need to request unnecessary medical evidence and paperwork where possible.Some medical paperwork is not included within the GP Contract and is therefore outside of core National Health Service work. It may attract charges in the same way some medical evidence letters, certificates, and reports are chargeable.There are currently no plans to develop further guidance around handling private medical requests. The British Medical Association provides guidance to general practitioners on its website on fees for medical evidence, and on general practice responsibility in responding to private health care.