Written questions by Gibson.

How many women in Wiltshire accessed perinatal mental health services in each of the last five years; and what the average waiting time was for an initial assessment in each year.

Information on the number of women accessing perinatal mental health services in Wiltshire, provided by the NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board, the Avon and Wiltshire Mental Health Partnership NHS Trust, and Wiltshire Health and Care over the last five years to May 2025, is available at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics NHS England has advised that the average time between referral and assessment for patients using the Bath and North East Somerset, Swindon and Wiltshire specialist community perinatal mental health team was as follows:12 days in 2021/22;12 days in 2022/23;eight days in 2023/24;nine days in 2024/25; andseven days in 2025/26, from April to June.

Whether the delivery plan for ME/CFS will include a strategic framework to support research into treatment development.

The Government funds research through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC).We have assessed the myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), research portfolio funded through the NIHR and the MRC and acknowledge that this is an under-funded area. The level of funding awarded is directly related to the number and quality of applications received and we have historically received a small number of applications for funding in this area. Between 2019/20 and 2023/24, the NIHR committed approximately £3.7 million to research projects and programmes on ME/CFS. In the same period, the MRC committed approximately £2.9 million to research into ME/CFS. We welcome funding applications for research into ME/CFS. These applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.We aim to publish the final delivery plan for ME/CFS shortly. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating condition. Following the publication of the final delivery plan, we will monitor the progress across all actions in the delivery plan, with project management arrangements in place to ensure timely implementation and periodical reports to stakeholders as appropriate.Together with the MRC, we are actively exploring next steps for research in ME/CFS, and we will outline in the delivery plan further research actions and the additional support we will offer to the research community to increase the volume and quality of applications. This includes a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical inventions for post-acute infection syndromes and associated conditions, including ME/CFS. This funding opportunity is a key component of our response to the need for further research-based evidence related to the diagnosis, management, and treatment of post-acute infection conditions, including ME/CFS. We are also planning an NIHR and MRC hosted showcase event for post-acute infection conditions, including ME/CFS and long COVID, research later this year to stimulate further research in this field.

What steps his Department is taking to monitor progress on the delivery plan for myalgic encephalomyelitis/chronic fatigue syndrome.

The Government funds research through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC).We have assessed the myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), research portfolio funded through the NIHR and the MRC and acknowledge that this is an under-funded area. The level of funding awarded is directly related to the number and quality of applications received and we have historically received a small number of applications for funding in this area. Between 2019/20 and 2023/24, the NIHR committed approximately £3.7 million to research projects and programmes on ME/CFS. In the same period, the MRC committed approximately £2.9 million to research into ME/CFS. We welcome funding applications for research into ME/CFS. These applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.We aim to publish the final delivery plan for ME/CFS shortly. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating condition. Following the publication of the final delivery plan, we will monitor the progress across all actions in the delivery plan, with project management arrangements in place to ensure timely implementation and periodical reports to stakeholders as appropriate.Together with the MRC, we are actively exploring next steps for research in ME/CFS, and we will outline in the delivery plan further research actions and the additional support we will offer to the research community to increase the volume and quality of applications. This includes a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical inventions for post-acute infection syndromes and associated conditions, including ME/CFS. This funding opportunity is a key component of our response to the need for further research-based evidence related to the diagnosis, management, and treatment of post-acute infection conditions, including ME/CFS. We are also planning an NIHR and MRC hosted showcase event for post-acute infection conditions, including ME/CFS and long COVID, research later this year to stimulate further research in this field.

What recent assessment he has made of the adequacy of (a) UK Research and Innovation and (b) National Institute for Health and Care Research funding for biomedical research into (i) myalgic encephalomyelitis and (ii) chronic fatigue syndrome.

The Government funds research through the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC).We have assessed the myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), research portfolio funded through the NIHR and the MRC and acknowledge that this is an under-funded area. The level of funding awarded is directly related to the number and quality of applications received and we have historically received a small number of applications for funding in this area. Between 2019/20 and 2023/24, the NIHR committed approximately £3.7 million to research projects and programmes on ME/CFS. In the same period, the MRC committed approximately £2.9 million to research into ME/CFS. We welcome funding applications for research into ME/CFS. These applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.We aim to publish the final delivery plan for ME/CFS shortly. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating condition. Following the publication of the final delivery plan, we will monitor the progress across all actions in the delivery plan, with project management arrangements in place to ensure timely implementation and periodical reports to stakeholders as appropriate.Together with the MRC, we are actively exploring next steps for research in ME/CFS, and we will outline in the delivery plan further research actions and the additional support we will offer to the research community to increase the volume and quality of applications. This includes a new funding opportunity for a development award focussed on evaluating repurposed pharmaceutical inventions for post-acute infection syndromes and associated conditions, including ME/CFS. This funding opportunity is a key component of our response to the need for further research-based evidence related to the diagnosis, management, and treatment of post-acute infection conditions, including ME/CFS. We are also planning an NIHR and MRC hosted showcase event for post-acute infection conditions, including ME/CFS and long COVID, research later this year to stimulate further research in this field.

How much capital funding has been allocated to GP practices in Wiltshire in each of the last three years; and how many bids for premises improvement funding were (a) submitted and (b) approved.

The Primary Care Utilisation and Modernisation Fund will deliver upgrades to more than a thousand general practice surgeries across England this year. This includes nine schemes in the Bath, Northeast Somerset, Swindon and Wiltshire Integrated Care Board (BNSSW ICB), totalling a capital investment of £1.5 million. This is the first dedicated national capital fund for primary care since 2020.The following table shows the operational capital allocated to the BNSSW ICB for the last three financial years, which was subsequently prioritised at their discretion:Financial yearAllocation2025/26£40,800,0002024/25£59,300,0002023/24£43,400,000 This covers maintenance and other capital spend across the BNSSW ICB, and it is at local discretion whether an element is allocated to primary care.

What recent assessment he has made of the adequacy of GP funding relative to the proportion of NHS patient contact delivered in primary care.

The Carr-Hill formula, which underpins capitation payments to general practices (GPs), is designed to ensure that resources are directed to practices based on an estimate of their patient workload and unavoidable practice costs.It is a workload-based formula, introduced in 2004, that is designed to ensure that practices are reimbursed for their expected workload. Practices are paid more if their registered patients are expected to use services more based on past usage patterns of patients with similar characteristics. It takes into account factors, such as the sex and age of patients, morbidity and mortality, patient list turnover, and unavoidable costs based on geographical area.We recognise the importance of ensuring that funding for core services is distributed equitably between practices across the country, and will therefore review the Carr-Hill formula. Details of the review, including timeframes, will be confirmed in due course.We are investing an additional £889 million in GPs to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

What estimate he has made of the number and proportion of GP practices operating in premises not fit for purpose; and what steps his Department is taking to increase funding to address this issue.

The Government is committed to delivering a National Health Service that is fit for the future, with world class infrastructure across the entire NHS estate and confronting the challenges posed by historic underinvestment in primary care.There are 8,500 buildings that form the general practice (GP) estate nationally and we have worked with integrated care systems to develop infrastructure strategies which create a long-term plan for future estate requirements and investment for each local area and its specific needs. These strategies bring together planning for the existing and future primary care and secondary estate when considering how best to improve local service delivery.Bath, Northeast Somerset, Swindon & Wiltshire Integrated Care Board is responsible for commissioning, planning, securing, and monitoring GP services within Wiltshire through delegated responsibility from NHS England and works with local practices to ensure that the community continues to receive world class health services.We recently announced over 1,000 GP schemes which will benefit from this year's £102 million Primary Care Utilisation and Modernisation Fund, supporting GPs to improve the use of their existing buildings and space, boosting productivity and enabling delivery of more appointments. However, GPs are independent contractors who should routinely fund investment in maintaining their estate by utilising their own funds, borrowing, or through partnerships with third party developers.

What assessment his Department has made of the adequacy of GP premises in Wiltshire; and what recent estimate he has made of the number of practices operating in buildings considered unfit for purpose.

The Government is committed to delivering a National Health Service that is fit for the future, with world class infrastructure across the entire NHS estate and confronting the challenges posed by historic underinvestment in primary care.There are 8,500 buildings that form the general practice (GP) estate nationally and we have worked with integrated care systems to develop infrastructure strategies which create a long-term plan for future estate requirements and investment for each local area and its specific needs. These strategies bring together planning for the existing and future primary care and secondary estate when considering how best to improve local service delivery.Bath, Northeast Somerset, Swindon & Wiltshire Integrated Care Board is responsible for commissioning, planning, securing, and monitoring GP services within Wiltshire through delegated responsibility from NHS England and works with local practices to ensure that the community continues to receive world class health services.We recently announced over 1,000 GP schemes which will benefit from this year's £102 million Primary Care Utilisation and Modernisation Fund, supporting GPs to improve the use of their existing buildings and space, boosting productivity and enabling delivery of more appointments. However, GPs are independent contractors who should routinely fund investment in maintaining their estate by utilising their own funds, borrowing, or through partnerships with third party developers.

What research funding has been allocated to cholangiocarcinoma through (a) UK Research and Innovation and (b) the National Institute for Health and Care Research in the last five years.

The Department invests £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24, reflecting its high priority. These investments are pivotal to informing efforts to improve cancer prevention, treatment, and outcomes, including research into cholangiocarcinoma and cancers of the bile duct.In the period 2020/21 to 2024/25, the NIHR invested approximately £2 million across five chloangiocarcinoma research projects. NIHR’s wider investments in research infrastructure and workforce enabled another 90 non-NIHR funded cholangiocarcinoma research studies to take place in the same period. In addition, between 2020 and 2024, UK Research and Innovation committed a further £1.4 million to cholangiocarinoma research.NIHR investments have included studies looking at the clinical and cost effectiveness of drugs for treating cholangiocarcinoma, including futibatinib, and druvalumab in conjunction with gemcitabine and cisplatin.NIHR continues to welcome high quality, high impact funding applications for research into any aspect of human health and care, including cholangiocarcinoma and cancers of the bile duct.

What steps his Department is taking to raise public awareness of cholangiocarcinoma (a) symptoms and (b) risk factors.

I refer the Hon. Member to the answer given to the Hon. Member for Strangford on 23 January 2025 to Question 24851.

With reference to the NICE document entitled Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published on 29 October 2021, what progress has been made on implementing the guidelines in NHS trusts serving Wiltshire; and what monitoring is in place.

Integrated care boards (ICBs) are responsible for commissioning specialist myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), services that meet the needs of their population, subject to local prioritisation and funding. The process of commissioning services should take into account best practice guidance such as the National Institute for Health and Care Excellence’s (NICE) guidance on ME/CFS diagnosis and management, published in October 2021.The NICE’s guidelines provide recommendations on principles of care for people with severe ME/CFS, including hospital care and adopting a multidisciplinary approach involving access to various health and social care professionals based on needs, including diet and nutrition. NICE guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account when designing services to meet the needs of their local population, and to work towards their implementation over time.We are developing a final delivery plan for ME/CFS, which we aim to publish soon. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease throughout England, including in Wiltshire.Linked to the delivery plan, the Department has also been working with NHS England to develop an e-learning course on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes, including improving diagnosis.

What recent assessment he has made of the adequacy of access to specialist cystic fibrosis services through (a) NHS Trusts in (i) Bath and (ii) Swindon and (b) other routes for patients in Wiltshire.

NHS England commissions 47 specialised cystic fibrosis centres for adults and children across England. This includes the Bristol Adult Cystic Fibrosis Centre, based at Bristol Royal Infirmary, the Oxford Adult Cystic Fibrosis Centre, based at John Radcliffe Hospital, and the Wessex Adult Cystic Fibrosis Centre, based at Southampton General Hospital, which serve patients in Bath, Swindon, and the wider county of Wiltshire. Service specifications published by NHS England clearly define the standards of services, care, and outcomes that people can expect from these centres. Those service specifications aim to deliver improvements to life expectancy and quality of life for adults and children with cystic fibrosis. In addition, NHS England is supporting the optimal monitoring of patients with cystic fibrosis at home and supporting best practice in remote consultations. In August 2024, NHS England published the RightCare cystic fibrosis toolkit to help improve cystic fibrosis services and reduce unwarranted variation. The toolkit is designed to help support systems to understand key priorities and ways of optimising cystic fibrosis care, by providing key actions for improvement. The toolkit should be used in conjunction with the NHS England service specification for cystic fibrosis and the Cystic Fibrosis Trust Standards of Care. The National Institute for Health and Care Excellence has produced guidance on the diagnosis and management of cystic fibrosis, which specifies how to monitor the condition and manage the symptoms to improve quality of life.

What steps he is taking to ensure access to (a) cystic fibrosis transmembrane conductance regulator modulator therapies and (b) other cystic fibrosis treatments in rural parts of Wiltshire.

The National Institute for Health and Care Excellence (NICE) makes recommendations on whether licensed medicines should be routinely funded by the National Health Service in England based on a thorough assessment of the available evidence of clinical and cost effectiveness. The NHS in England is legally required to fund medicines recommended by NICE.In July 2024, NICE approved three disease modifying treatments, Orkambi, Symkevi, and Kaftrio, as treatment options for eligible NHS patients with cystic fibrosis, under the terms of a commercial agreement reached between NHS England and the manufacturer, Vertex. These treatments are now routinely funded by the NHS in England for eligible patients.NICE is also currently developing guidance for the NHS on whether vanzacaftor-tezacaftor-deutivacaftor can be recommended for routine funding for the treatment of cystic fibrosis. NICE is expecting to publish final guidance in August 2025.

What steps his Department is taking to provide (a) transport, (b) digital appointments and (c) other support to families managing the transition of cystic fibrosis patients from paediatric to adult care services in Wiltshire.

NHS England commissions 47 specialised cystic fibrosis (CF) centres for adults and children across England, in addition to supporting the optimal monitoring of patients with CF at home, and supporting best practice in remote consultations. Service specifications published by NHS England clearly define the standards of services, care, and outcomes that people, including those in Wiltshire, can expect from specialist CF centres. Those service specifications aim to deliver improvements to life expectancy and quality of life for adults and children with CF. The service specification for children with CF outlines that the transition from paediatric to adult services should be planned with the patient and their parents/carers with due regard to patient choice, and discussions should take place as early as possible about the process of transition and the options for adult care. The age of transition should be flexible, with the opportunity to visit the adult centre and meet key multi-disciplinary team members. There should be a detailed clinical handover and a documented paediatric and adult multi-disciplinary team member liaison. Specialist adult CF centres should demonstrate that they are actively engaging in the transition process for each child and are required to submit an annual audit report to commissioners of the experience of patients who transitioned during the year. In August 2024, NHS England published the RightCare cystic fibrosis toolkit to help improve CF services and reduce unwarranted variation. The toolkit recommends that outpatient services should consider a hybrid model of face-to-face and virtual consultations, as appropriate. It recommends that trusts should provide the infrastructure and resources to provide virtual consultations, including IT tools and virtual monitoring capability, but should not replace face-to-face care where it is more appropriate, dependent on clinical need, or preferred by individuals. To support patients, including those in Wiltshire, with the cost of travel, the National Health Service runs the Healthcare Travel Costs Scheme. The scheme allows patients to claim a refund of reasonable travel costs, provided that they meet the eligibility criteria and have been referred to hospital or other NHS premises for specialist NHS treatment or diagnostic tests. Further details are available at the following link:https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/

What steps his Department is taking to improve the diagnosis of myalgic encephalomyelitis in primary care settings in Wiltshire.

Integrated care boards (ICBs) are responsible for commissioning specialist myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), services that meet the needs of their population, subject to local prioritisation and funding. The process of commissioning services should take into account best practice guidance such as the National Institute for Health and Care Excellence’s (NICE) guidance on ME/CFS diagnosis and management, published in October 2021.The NICE’s guidelines provide recommendations on principles of care for people with severe ME/CFS, including hospital care and adopting a multidisciplinary approach involving access to various health and social care professionals based on needs, including diet and nutrition. NICE guidelines are not mandatory, but the Government does expect healthcare commissioners to take the guidelines fully into account when designing services to meet the needs of their local population, and to work towards their implementation over time.We are developing a final delivery plan for ME/CFS, which we aim to publish soon. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease throughout England, including in Wiltshire.Linked to the delivery plan, the Department has also been working with NHS England to develop an e-learning course on ME/CFS for healthcare professionals, with the aim of supporting staff to be able to provide better care and improve patient outcomes, including improving diagnosis.

How many and what proportion of NHS mental health referrals for under-18s were seen within four weeks in Wiltshire in the last 12 months.

The following table shows the number of new referrals in 2024/25 for those aged zero to 17 years old, and their associated waiting times, in Wiltshire: Count of referralsPercentage of referralsNew referrals6,755100%Referrals seen within 28 days2,90043%Referrals ending within 28 days without contact1,29019%Referrals not seen within 28 days2,56538%Source: Mental Health Services Dataset.

How much research funding his Department has allocated to cystic fibrosis research with clinical links to (a) hospitals and (b) research institutions in (i) Wiltshire and (ii) the South West in the last three years.

The National Institute for Health and Care Research awarded £2,037,265 to six studies on cystic fibrosis in 2022/23, 2023/24 and 2024/25 to hospitals and research institutions in the South West region of England, including those in Wiltshire.

What assessment he has made of the adequacy of education, health and care plans for children with cystic fibrosis in Wiltshire; and what steps he is taking to help support local authorities to improve those plans.

We are committed to ensuring that people living with cystic fibrosis have access to appropriate support and services, so that they can fulfil their potential and lead happy, healthy and productive lives.NHS England commissions 47 specialised cystic fibrosis centres for adults and children across England. This includes the children’s specialist cystic fibrosis service based at Southampton Children’s Hospital, which serves patients in Wiltshire. Service specifications published by NHS England clearly define the standards of services, care and outcomes that people can expect from these centres. Those service specifications aim to deliver improvements to life expectancy and quality of life for children with cystic fibrosis.Where a local authority does not meet its duties, the Department for Education can take action that prioritises children’s needs and supports local areas to bring about rapid improvement. The Department for Education works to monitor, support, and challenge local authorities, working closely with NHS England to tackle weaknesses that sit with health partners.For this reason, the Department of Health and Social Care has not specifically made a formal assessment of the adequacy of education, health, and care plans for children with cystic fibrosis in Wiltshire.

What recent assessment he has made of trends in waiting times for ADHD assessments in (a) children and (b) adults in the last five years; and what steps he is taking to reduce these delays.

Lord Darzi’s independent review of the National Health Service, published in September 2024, highlighted the severe delays for accessing attention deficit hyperactivity disorder (ADHD) assessments and that demand for assessments for ADHD has grown significantly in recent years.NHS England has established an ADHD taskforce which is bringing together those with lived experience with experts from the NHS, education, charity and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim is expected to be published shortly, with the final report expected in summer 2025.For the first time, NHS England published management information on ADHD waits at a national level on 29 May 2025 as part of its ADHD data improvement plan; it will soon release technical guidance to integrated care boards (ICBs) to improve recording of ADHD data, with a view to improving the quality of ADHD waits data. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.

How many full-time equivalent MS specialist nurses are employed by the NHS in England; and steps he plans to take to increase their number.

The Department does not hold information on the number of full time equivalent multiple Sclerosis (MS) nurses employed in the National Health Service in England.The Nursing and Midwifery Council (NMC) sets the standards for nurse education. There is no NMC requirement for specific post-graduate education for nurses working with those with MS; however, the education and practice learning that prepares nurses to join the register covers learning outcomes to support good care.Local employers will plan the specialist nurse workforce they require to meet population needs. The NHS funds several post registration education programmes that supports the development of the knowledge and skills required in practice. Each nurse working in the NHS also has access to a continuing professional development budget of £1,000 over three years to enable them to develop their knowledge and skills.