Written questions by Niblett.

What plans his department has to ensure equitable access and service provision for patients with functional neurological disorder (FND) across South Derbyshire.

NHS England’s updated Specialised Neurology Service Specification, published in August 2025, includes specific reference to functional neurological disorder (FND). It states that all specialised neurology centres must include access to treatment services for FND. The service specification is available at the following link:https://www.england.nhs.uk/publication/specialised-neurology-services-adults/There are a number of other national-level initiatives supporting service improvement and better care for patients with neurological conditions, including FND, such as the Getting It Right First Time Programme for Neurology and the Neurology Transformation Programme, which aim to improve care for people by reducing variation and delivering care more equitably across England, including for people in South Derbyshire.Additionally, we have set up a UK Neuro Forum facilitating formal, twice-yearly meetings across the Department, NHS England, the devolved administrations and health services, and the Neurological Alliances of all four nations. The new forum brings key stakeholders together, to share learning across the system and to discuss challenges, best practice examples, and potential solutions for improving the care of people with neurological conditions, including FND.

What steps his Department is taking to help support individuals with pelvic health conditions through the Pelvic Partnership; and what specific support and service provision is currently available in Derbyshire.

We are rolling out perinatal pelvic health services to improve the prevention, identification, and referral to treatment for pelvic health problems during pregnancy and at least one year following birth. As of January 2026, 36 of the 42 local systems have perinatal pelvic health services in place, and NHS England are working closely with the remaining areas which do not yet have fully established services in place. The Department and NHS England do not support individuals through the charity the Pelvic Partnership.In North Derbyshire, there is a fully operational Perinatal Pelvic Health Service delivered by a dedicated multidisciplinary team.Within Derby City and South Derbyshire, an established women’s health physiotherapy service is in place and is currently being expanded. The service delivers pelvic floor clinics and pelvic girdle pain clinics.The Chesterfield Royal Hospital NHS Foundation Trust and the University Hospitals of Derby and Burton NHS Foundation Trust also provide assessment and treatment for women and men experiencing bladder, bowel, and pelvic floor conditions.

How much his Department has spent on Microsoft software licenses in the last 12 months.

DHSC spent £4.3m on Microsoft licensing for internal use for the period 1 February 2025 to 31 January 2026.All purchases are based upon a valid business requirement and utilise national pricing agreements negotiated by the Crown Commercial Service to ensure value for the taxpayer.

What vetting procedures are in place to ensure care agencies providing non UK workers in the care industry ensure the safety of patients before allowing workers to commence a caring role.

Care agencies who carry out a regulated activity must be registered by the Care Quality Commission (CQC) and are expected to comply with relevant regulations. Where a care agency does not carry out a regulated activity but supplies workers to a regulated care provider, the legal duty to comply with CQC regulations sits with the registered provider using the agency and the registered manager.Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 sets out that it is the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role. Further information on Regulation 19 is available at the following link:https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-19Registered providers are also expected to comply with Regulation 18: Staffing, which sets out a provider’s responsibility to deploy enough suitably qualified, competent, and experienced staff. Further information on Regulation 18 is available at the following link:https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-18The CQC can assess compliance with these regulations through assessment and monitoring activity. Where a breach of regulation or non-compliance is identified, the CQC can take regulatory action.An Enhanced Disclosure and Barring Service (DBS) check must be undertaken prior to the recruitment of all care workers. In line with the CQC guidance for DBS checks, staff working with vulnerable adults can only start work before a DBS certificate is received if they have had a DBS Adult First Check, are appropriately supervised, and do not escort people away from the premises unless accompanied by someone with a DBS check.

Whether he has had discussions with NICE on its Final Draft Guidance which does not recommend CAR-T therapy for relapsed or refractory Mantle Cell Lymphoma.

Department officials regularly discuss a range of issues with colleagues in the National Institute for Health and Care Excellence (NICE), including in relation to the development of guidance on individual products.NICE develops its recommendations on new medicines independently on the basis of a thorough assessment of the available evidence and through extensive engagement with interested parties. NICE is currently re-evaluating the CAR-T therapy brexucabtagene autoleucel (Tecartus) to determine whether it can be recommended for routine National Health Service use, taking into account real-world evidence generated through its use in the Cancer Drugs Fund.

What consideration his department has made of the potential merits of providing parity in pay and conditions between primary care nursing staff and their Agenda for Change colleagues in the NHS.

The Government is committed to ensuring the general practice nursing workforce is sustainable, supported and valued for the work they do.The Government looks to the independent pay review bodies for a pay recommendation for National Health Service staff, including both contractor and salaried general practitioners (GPs). They consider a range of evidence from organisations including the Government, the NHS and trade unions to reach their recommendations.The independent review body on Doctors’ and Dentists’ Remuneration (DDRB) recommended an uplift of 4% to the pay ranges for salaried GPs, and to GP contractor pay. As with the previous year, we accepted the DDRB’s pay recommendation. We provided an increase to core funding for practices to allow this 4% pay uplift, on top of the provisional 2.8% uplift already provided, to be passed on to salaried and contractor GPs. The additional funding also allows for pay uplifts for other salaried general practice staff, including nurses. We expect GP contractors to implement pay rises to other practice staff in line with the uplift in funding they have received.As self-employed contractors to the NHS, it is up to general practices how they distribute pay and benefits to general practice nurses and other staff. General practice contractual arrangements do not place any specific obligations on practices regarding general practice nurse terms and conditions.We are investing an additional £1.1 billion in general practice to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26, representing the biggest cash increase in over a decade. The 8.9% boost to the GP contract in 2025/26 is greater than the 5.8% growth to the NHS budget overall.

Pursuant to the Answer of 11 December 2025 to Question 97018, what proportion of his Department expenditure on Microsoft Software licenses and services was allocated to (a) new service implementations and (b) renewal or maintenance of existing system; and how this compares to the previous year’s expenditure in each category.

The following table shows the information requested:YearNew Service ImplementationsRenewal and Maintenance of existing Systems4 December 2024 – 5 December 202515.2%84.8%4 December 2023 – 5 December 20240%100%Source: Department of Health and Social Care

What proportion of spending on Microsoft software licenses and services between (a) 4 December 2024 and 5 December 2025 and (b) 4 December 2023 and 5 December 2024 was allocated to (i) new service implementations and (ii) renewal and maintenance of existing systems.

The following table shows the proportion of spending on Microsoft software licenses and services between 4 December 2024 and 5 December 2025, and between 4 December 2023 and 5 December 2024 that was allocated to new service implementations and renewal, and to the maintenance of existing systems:PeriodNew service implementationsRenewal and maintenance of existing systems4 December 2024 to 5 December 202515.2%84.8%4 December 2023 to 5 December 20240%100%

How much his Department has spent on software licences from Microsoft in the last 12 months; and what proportion this represents of his Department’s total technology spend.

For the period 4 December 2024 to 5 December 2025, the Department spent £4.8 million on Microsoft Software licenses and services. During this period this spend accounted for 25.2% of the overall internal technology spend.

Whether his Department has made an assessment of the potential impact of sites previously used to dump fly ash now used for house building on public health.

The UK Health Security Agency (UKHSA) has not undertaken any overarching assessment of the potential impact on public health from housebuilding on sites previously used to deposit fly ash.Assessments of potential land contamination used for housing are governed at national level by the Department for Environment, Food & Rural Affairs under contaminated land legislation and the Ministry of Housing, Communities and Local Government under planning legislation. Local authorities assess land within their areas with respect to contaminated land, and Local Planning Authorities address legacy contamination through local plans and development management.In England and Wales, local authorities are required to assess their areas to identify and remove unacceptable risks to public health and the environment, and act as a regulator to ensure that contaminated land is made suitable for its current use. Specific development sites brought into use for housing should be adequately risk-assessed, and any required remediation overseen, within the planning process.

What steps his Department is taking to (a) ensure nursing graduates can find Band 5 roles upon graduation and (b) increase the number of roles for newly registered nurses.

On 11 August 2025, the Government announced the Graduate Guarantee for nurses and midwives. The Guarantee will ensure there are enough positions for every newly qualified nurse in England. The package of measures will unlock thousands of jobs and will ensure thousands of new posts are easier to access by removing barriers for National Health Service trusts, creating opportunities for graduates and ensuring a seamless transition from training to employment.

For what reason older people under 75 are not eligible for the NHS covid-19 autumn booster in 2025.

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent expert committee which reviews the latest data on COVID-19 risks, vaccine safety, and effectiveness and advises the department on the approach to vaccination and immunisation programmes. The JCVI has published advice for future COVID-19 vaccination campaigns in autumn 2025, spring 2026, autumn 2026, and spring 2027. The Government has accepted JCVI advice for autumn 2025. The Government is considering the JCVI’s advice for 2026 and spring 2027 carefully and will respond in due course.The primary aim of the national COVID-19 vaccination programme remains the prevention of serious disease (hospitalisations and deaths) arising from COVID-19. The JCVI assessment indicates that the oldest age cohorts and individuals who are immunosuppressed are the two groups who continue to be at higher risk of serious disease.Therefore, in autumn 2025, a COVID-19 vaccination will be offered to:adults aged 75 years and over;residents in a care home for older adults;individuals aged 6 months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the UK Health Security Agency Green Book).

What proportion of the £10 billion NHS technology investment will be spent on software licensing.

The information requested is not available.

Whether his Department has made an assessment of the potential merits of comedy within social prescribing.

The Department recognises the value that social prescribing can play in supporting people’s health and wellbeing. This includes activities such as the creative arts, as well as cultural activities.

What steps his Department is taking to collaborates with the Health Innovation Network to support local innovation in NHS care pathways.

The Government continues to fund and support the Health Innovation Network to help the adoption of local innovation into National Health Service care pathways, and digital innovation into local NHS services. Each of the 15 regional networks deliver services for their local population, as well as working as a national network.The network’s Innovation Collaborative for Digital Health exemplifies their support for digital innovation in local NHS services, and the scaling of these innovations across the NHS, as the collaborative supports 487,000 people with technology-enabled remote monitoring at home.Since 2020, over 340,000 hours of healthcare staff capacity has been released through the network’s national programmes.

What steps his Department is taking with the Health Innovation Network to support digital innovation in local NHS services.

The Government continues to fund and support the Health Innovation Network to help the adoption of local innovation into National Health Service care pathways, and digital innovation into local NHS services. Each of the 15 regional networks deliver services for their local population, as well as working as a national network.The network’s Innovation Collaborative for Digital Health exemplifies their support for digital innovation in local NHS services, and the scaling of these innovations across the NHS, as the collaborative supports 487,000 people with technology-enabled remote monitoring at home.Since 2020, over 340,000 hours of healthcare staff capacity has been released through the network’s national programmes.

With reference to the publication entitled Health Technical Memorandum 04-01: Safe water in healthcare premises, updated on 27 August 2024, what processes are in place to help support the (a) NHS and (b) healthcare sector with the implementation of the NHS Estates Technical Bulletin No.2024/3.

The Health Technical Memorandum 04-01: Safe water in healthcare premises was last updated in 2016, and is currently being reviewed for the publication of an update in 2026.The NHS Estates Technical Bulletin (NETB) No.2024/3: Designing safe spaces for patients at high risk of infection from nontuberculous mycobacteria and other waterborne pathogens was created in response to a recent outbreak of mycobacterium abscessus (Mab), a nontuberculous mycobacterium, and the resulting risks for vulnerable patients in specialised wards/units. The NETB was created in response to a Regulation 28 report from the coroner for Cambridgeshire and Peterborough.National Health Service organisations are responsible for reviewing their own organisational risks, in line with the guidance, for this specialist group, and for managing its implementation at a local level.

Whether his Department plans to enable all day booking at GP surgeries.

The 2025/26 GP Contract has been updated to give patients the right to access help electronically, including requesting appointments, throughout the duration of core practice hours.All practices in England are required to offer online and video consultation tools, secure electronic communication methods, and online facilities to provide and update personal information.Practices are required to offer patients an appropriate response on the day they contact the practice, or the next day if they contact the practice in the afternoon, according to the urgency of their clinical needs and other circumstances. An appropriate response could, for example, involve inviting the patient to an appointment, providing appropriate advice or care by another method, signposting to the patient to appropriate services, or communicating with the patient to request more information.

Whether he plans to abolish (a) Primary Care Support England and (b) any other NHS organisations, in the context of the abolition of NHS England.

Work is progressing at pace to map functions, appraise options, and inform decision making on where NHS England’s functions will best sit.There are important choices to be made, and ministers and senior Department officials will work with the new executive team in NHS England, led by Sir Jim Mackey, to ensure the new joint centre will operate more efficiently, cut out unnecessary bureaucracy, and empower those working on the frontline.In taking forward the work, we will ensure that we continue to evaluate impacts of all kinds.

Pursuant to the Answer of 28 March 2025 to Question 40872 on Epilepsy: Drugs, what steps he is taking to support patients whose neurologist has specified that Levetiracetam must come from Millfarm.

The Department is not aware of any supply issues with levetiracetam tablets from the manufacturer, Milpharm. Pharmacies can obtain stocks from their usual wholesalers.