Written questions by Gibson.

Whether he has made an assessment of the potential merits of implementing a dedicated diagnostic pathway for brain tumours.

The Department is working with NHS England to improve diagnostic processes in the National Health Service for all patients with cancer, including those with brain tumours.To support faster and earlier diagnosis, the Department will address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce cancer waits. NHS England is delivering a range of interventions to support general practices in diagnosing brain cancer earlier, for example through the early cancer diagnosis service specification for primary care networks. This specification is designed to support improvements in rates of early cancer diagnosis by requiring primary care networks to review the quality of their general practices’ referrals for suspected cancer and take steps to improve this, where appropriate.The Department also set out expectations for renewed focus on cancer targets in the Elective Reform plan, published on 6 January 2025. NHS providers have been asked to identify local opportunities in both community diagnostic centres (CDCs) and hospital based diagnostic services to improve performance against the Faster Diagnosis Standard, in order to reduce the number of patients waiting too long for a confirmed diagnosis of cancer. Any new CDC will be expected to include specific capacity for cancer testing as part of its CDC activity plans, enabled either through direct provision or via freeing up acute hospital capacity for more complex cancer tests.Later this year, the Department will publish a National Cancer Plan, which will have patients at its heart and will cover the entirety of the cancer pathway, including diagnosis. It will seek to improve every aspect of cancer care, to improve the experiences and outcomes for people with cancer, including those with brain cancer.Given this wider ongoing work, the Department has not made a specific assessment on the merits of implementing a dedicated diagnostics pathway for brain tumours.

Whether he has made an assessment of the potential impact of an increase in staffing costs in voluntary, community and social enterprise (VCSE) organisations on their ability to provide services for the NHS through integrated care systems.

Within integrated care systems, integrated care boards (ICBs) have a statutory responsibility to arrange and provide healthcare services that meet the needs of their populations. Additionally, ICBs work closely with the voluntary, community, and social enterprise (VSCE) sector, which includes the commissioning and delivery of services and, in some cases, by appointing representatives from the VSCE sector to their boards.The Department has not made an assessment of the potential impact of an increase in staffing costs in VSCE organisations. VCSE organisations, as independent organisations such as charities and social enterprises, are free to develop and adapt their own terms and conditions of employment, which includes pay scales.It is for those organisations to determine what is affordable within the financial model they operate, and how to recoup any additional costs they face if they choose to utilise the terms and conditions of National Health Service staff on the Agenda for Change contract.NHS England has issued guidance on the implementation of the 2024/25 pay awards, which is available at the following link:https://www.england.nhs.uk/publication/revenue-finance-and-contracting-guidance-for-2024-25/The Government has also more than doubled the Employment Allowance to £10,500, meaning that more than half of businesses, including charities, with National Insurance contribution (NIC) liabilities will either gain or see no change next year. The Government is also expanding the eligibility of the Employment Allowance by removing the £100,000 eligibility threshold, to simplify and reform employer NICs so that all eligible employers now benefit. Employers will also continue to benefit from employer NIC reliefs, including for hiring those that are under 21 years old and apprentices under 25 years old, where eligible.

How many 999 calls were received by ambulance services in the South West in each month since January 2024; and what the staffing levels were for paramedics in those services over the same period.

NHS England publishes official workforce and ambulance 999 call statistics. The following table provides data on the number of full time equivalent (FTE) paramedics employed at the South Western Ambulance Service NHS Foundation Trust between January 2024 and January 2025, as well as data on 999 calls answered by the trust from January 2024 to March 2025:PeriodCalls answeredFTE Paramedic staff levelsJanuary 202485,3282,042February 202480,2592,049March 202487,5662,101April 202477,9712,104May 202487,4462,096June 202486,9282,100July 202488,3712,111August 202484,1962,114September 202486,1952,160October 202498,5062,178November 202494,6582,194December 2024101,2232,189January 202588,5312,206February 202577,595N/AMarch 202584,825N/ASource: data is from NHS England’s NHS workforce statistics and Ambulance Quality Indicators data sets, with further information about both available, respectively, at the following two links:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statisticshttps://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

How many and what proportion of ambulance handovers at hospitals exceeded (a) 30 minutes, (b) one hour and (c) two hours in the South West in each month since January 2024.

NHS England publishes official statistics for ambulance handover times. The following table provides the number and proportion of ambulance handovers that were over 30 minutes and over one hour for the South Western Ambulance Service NHS Foundation Trust, each month since January 2024:Number of handoversProportion of all handoversPeriodOver 30 minutesOver 60 minutesOver 30 minutesOver 60 minutesJanuary 202418,44411,20748.5%29.5%February 202416,5909,87846.8%27.9%March 202416,99010,04944.5%26.3%April 202415,2378,51041.3%23.1%May 202416,3039,09842.4%23.7%June 202416,2349,18343.8%24.8%July 202415,4748,00140.1%20.7%August 202413,5386,30034.8%16.2%September 202417,1029,52345.4%25.3%October 202418,36310,95949.5%29.5%November 202417,1949,78847.0%26.8%December 202420,16512,18252.2%31.5%January 202519,61711,80253.0%31.9%February 202517,0129,35349.1%27.0%March 202517,9939,67846.2%24.9%Source: data is from NHS England’s Ambulance Quality Indicators, with further information available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/Official statistics for the number and proportion of ambulance handovers that exceed two hours is not available.

What the longest recorded ambulance response time was in the South West in (a) 2024 and (b) 2025 to date.

NHS England publishes official statistics for ambulance service performance. These statistics include average response time performance by category of incident. However, official statistics are not available on the proportion or longest response times. The following table shows the average response times for the South Western Ambulance Service NHS Foundation Trust, in hours, minutes and seconds, broken down by category, from April 2024 to March 2025:Category 1Category 2Category 3Category 4April 20240:09:280:36:481:39:181:45:02May 20240:09:420:40:402:06:242:07:45June 20240:09:410:43:142:07:441:59:21July 20240:09:280:39:091:48:251:46:47August 20240:09:390:32:291:22:391:26:47September 20240:09:410:42:492:12:562:28:53October 20240:10:270:57:383:48:294:06:36November 20240:10:160:59:033:44:063:12:55December 20240:09:571:00:324:00:163:58:37January 20250:09:410:51:452:35:273:36:47February 20250:09:100:40:282:14:132:49:12March 20250:09:000:37:021:57:132:25:05

How many and what proportion of emergency ambulance calls met the national response time targets for each category of call in the South West in each month since January 2024.

NHS England publishes official statistics for ambulance service performance. These statistics include average response time performance by category of incident. However, official statistics are not available on the proportion or longest response times. The following table shows the average response times for the South Western Ambulance Service NHS Foundation Trust, in hours, minutes and seconds, broken down by category, from April 2024 to March 2025:Category 1Category 2Category 3Category 4April 20240:09:280:36:481:39:181:45:02May 20240:09:420:40:402:06:242:07:45June 20240:09:410:43:142:07:441:59:21July 20240:09:280:39:091:48:251:46:47August 20240:09:390:32:291:22:391:26:47September 20240:09:410:42:492:12:562:28:53October 20240:10:270:57:383:48:294:06:36November 20240:10:160:59:033:44:063:12:55December 20240:09:571:00:324:00:163:58:37January 20250:09:410:51:452:35:273:36:47February 20250:09:100:40:282:14:132:49:12March 20250:09:000:37:021:57:132:25:05

What the average ambulance response time was for category (a) one, (b) two, (c) three and (d) four calls in each NHS ambulance trust operating in the South West in each of the last 12 months.

NHS England publishes official statistics for ambulance service performance. These statistics include average response time performance by category of incident. However, official statistics are not available on the proportion or longest response times. The following table shows the average response times for the South Western Ambulance Service NHS Foundation Trust, in hours, minutes and seconds, broken down by category, from April 2024 to March 2025:Category 1Category 2Category 3Category 4April 20240:09:280:36:481:39:181:45:02May 20240:09:420:40:402:06:242:07:45June 20240:09:410:43:142:07:441:59:21July 20240:09:280:39:091:48:251:46:47August 20240:09:390:32:291:22:391:26:47September 20240:09:410:42:492:12:562:28:53October 20240:10:270:57:383:48:294:06:36November 20240:10:160:59:033:44:063:12:55December 20240:09:571:00:324:00:163:58:37January 20250:09:410:51:452:35:273:36:47February 20250:09:100:40:282:14:132:49:12March 20250:09:000:37:021:57:132:25:05

What steps his Department is taking to help improve the timeliness of medication dispensing for inpatients awaiting discharge.

The Department and NHS England recognise the need for patients who are ready to go home to be discharged as quickly as possible, both for their benefit and to improve the efficiency of hospitals. Pharmacy-related delays can affect timely hospital discharge for medically fit patients, impacting patient experience, patient flow, and hospital efficiency.Work is underway nationally and locally to improve discharge processes and reduce avoidable delays. New discharge metrics are supporting providers and systems to identify the causes of delay, including those related to pharmacy, and address them.

Whether his Department plans to publish outcomes data from quality improvement projects delivered through the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board.

A Quality Account is a report of the quality of services offered by a National Health Service healthcare provider. NHS organisations are required to produce quality accounts annually, which are an important way for local NHS services to demonstrate the effectiveness of, and show improvements in, the services they deliver. The Bath and North-East Somerset, Wiltshire and Swindon Integrated Care Board (ICB) has published quality assurance information in their annual report, which can be found on the respective ICB website, at the following link:https://bsw.icb.nhs.uk/wp-content/uploads/sites/6/2024/08/QOX_BSW-ICB-Annual-Report-and-Accounts-2023-24_FINAL_unsigned.pdf

What assessment he has made of the adequacy of the existing skills base across NHS trusts within Integrated Care Systems to deliver improvements based on (a) human factors and (b) systems thinking.

No assessment has been made.

What metrics are used to evaluate the effectiveness of primary care network toolkits for meeting their intended objectives within integrated care boards; and what steps his Department takes to monitor those metrics.

The Primary Care Network (PCN) Estates Toolkit was developed as a practical support tool, to provide PCNs with a flexible framework and to support the process for producing robust primary care investment plans with priorities that align to integrated care systems strategies. The toolkit does not include metrics or patient feedback and therefore we are unable to comment on their effectiveness in this regard.

How patient feedback is incorporated into the (a) evaluation and (b) refinement of primary care network toolkits.

The Primary Care Network (PCN) Estates Toolkit was developed as a practical support tool, to provide PCNs with a flexible framework and to support the process for producing robust primary care investment plans with priorities that align to integrated care systems strategies. The toolkit does not include metrics or patient feedback and therefore we are unable to comment on their effectiveness in this regard.

What recent assessment his Department has made of the effectiveness of Quality Improvement reports in driving measurable improvements in patient care outcomes across NHS trusts.

A Quality Account is a report of the quality of services offered by a National Health Service healthcare provider. They are published annually and are an important way for local NHS services to demonstrate the effectiveness of, and show improvements in, the services they deliver.There are several measures in place for holding NHS trusts, foundation trusts, and integrated care boards (ICBs) to account for delivery, and for supporting improvement in operational performance, quality, and patient outcomes.NHS England oversees NHS trusts, foundation trusts, and ICBs through the NHS Oversight Framework, and has proposed updates to this in the draft NHS Performance Assessment Framework, which was published in March 2025. NHS England will shortly consult upon the revised approach, which includes quality metrics that judge how effectively organisations are delivering high quality, safe care. NHS England plans to publish a final framework by July of this year.In addition, within their joint forward plans, ICBs are required to set out quality objectives that reflect system intelligence, with clearly aligned metrics on processes and outcomes to evidence ongoing sustainable and equitable improvement.

If he will publish data on the average waiting times for discharge medications in hospital trusts within Wiltshire.

The Department does not hold data in the format requested. The data that is recorded relates to the dispensing time, from a prescription arriving in the dispensary to the time the medication is made available for the patient. The following table shows the most recent data available, for April 2025, regarding the average dispensing time for a prescription in the NHS South West region:RegionAverage time per discharge prescriptionNHS South West77 minutes

What assessment his Department has made of the potential impact of hospital pharmacy delays on discharge times for patients who are medically fit to leave.

The Department and NHS England recognise the need for patients who are ready to go home to be discharged as quickly as possible, both for their benefit and to improve the efficiency of hospitals. Pharmacy-related delays can affect timely hospital discharge for medically fit patients, impacting patient experience, patient flow, and hospital efficiency.Work is underway nationally and locally to improve discharge processes and reduce avoidable delays. New discharge metrics are supporting providers and systems to identify the causes of delay, including those related to pharmacy, and address them.

What steps NHS England is taking to monitor (a) compliance with and (b) the implementation of findings and recommendations from quality improvement reports in (i) trusts and (ii) integrated care systems.

A Quality Account is a report of the quality of services offered by a National Health Service healthcare provider. They are published annually and are an important way for local NHS services to demonstrate the effectiveness of, and show improvements in, the services they deliver.There are several measures in place for holding NHS trusts, foundation trusts, and integrated care boards (ICBs) to account for delivery, and for supporting improvement in operational performance, quality, and patient outcomes.NHS England oversees NHS trusts, foundation trusts, and ICBs through the NHS Oversight Framework, and has proposed updates to this in the draft NHS Performance Assessment Framework, which was published in March 2025. NHS England will shortly consult upon the revised approach, which includes quality metrics that judge how effectively organisations are delivering high quality, safe care. NHS England plans to publish a final framework by July of this year.In addition, within their joint forward plans, ICBs are required to set out quality objectives that reflect system intelligence, with clearly aligned metrics on processes and outcomes to evidence ongoing sustainable and equitable improvement.

What assessment his Department has made of the potential impact of changes to the eligibility criteria for the Winter Fuel Payment on (a) cold-related illness and (b) hospital admissions amongst older adults in Wiltshire.

A specific assessment relating to older adults in Wilshire has not been produced. The Department for Work and Pensions published an equality analysis of the changes to eligibility for the winter fuel payment last summer, which is available at the following link:https://www.gov.uk/government/publications/responses-to-freedom-of-information-requests-on-equality-impact-assessments-produced-for-targeting-winter-fuel-payment/dwp-freedom-of-information-responseThe Government has continued to take action to support vulnerable households with cost-of-living pressures, including extending the Household Support Fund until March 2026, thereby providing local authorities with an additional £742 million of funding.

What assessment his Department has made of the potential impact of a national prostate cancer screening programme on (a) early diagnosis rates and (b) health inequalities.

The Department is guided on screening policy by the UK National Screening Committee (UK NSC). The committee has commissioned a university to carry out a high quality review and cost effectiveness model of the evidence for a national prostate cancer screening programme. This includes targeted approaches to high risk groups and an offer to all men defined by age.However, their previous review advised against screening because the current best test, the prostate specific antigen test, is not accurate. As a result, it can lead to some men receiving false reassurance when they do actually have prostate cancer, and others receiving unnecessary further tests when they did not have prostate cancer.Black men are twice as likely as white men to get prostate cancer. But using an inaccurate test on this group of men might not reduce health inequalities. Instead, it risks leading to greater levels of misdiagnosis in this group. We need a better test, which is why the Government has invested £16 million in the TRANSFORM trial, to look for a better test. This trial will ensure that one in ten participants are black men.Many prostate cancers are very slow growing and many men can live and die with prostate cancer, without ever showing any symptoms. Early diagnosis in prostate cancer can lead to unnecessary interventions and treatment that can have nasty and life altering side effects, for a cancer that would never have caused harm. That is why the UK NSC, when reviewing the evidence for a screening programme, must balance the benefits, including a reduction in mortality, against the harms. Only where the committee is confident that high quality evidence suggests a programme will do more good than harm will it be recommended.

What steps his Department is taking to help increase the number of high street pharmacies.

Pharmacies play a vital role in our healthcare system, and the Government recognises the integral role they play within our communities, as an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.Community pharmacies are private businesses that provide NHS funded services. Most pharmacies are not directly commissioned or contracted by the NHS, instead contractors apply to gain entry to the NHS pharmaceutical list and if an application is approved, a pharmacy can open and start providing services.Local authorities are required to undertake a pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served by local pharmacies, and must keep these assessments under review. Integrated care boards (ICBs) give regard to the PNAs when reviewing applications from new contractors. Contractors can also apply to open a new pharmacy to offer benefits to patients that were not foreseen by the PNA. If there is a need for a new local pharmacy to open and no contractors apply to open a pharmacy and fill the gap, ICBs can commission a new pharmacy to open outside of the market entry processes and fund the contract from the ICBs’ budgets.The Pharmacy Access Scheme helps protect access to pharmacies in areas where there are fewer pharmacies and higher health needs, so that no area is left without access to local, physical NHS pharmaceutical services.In general, despite a reduction in the number of pharmacies in recent years, patient access to pharmacies remains good, and continues to be better in the most deprived areas when compared with the least deprived.

What steps his Department is taking to prevent the creation of pharmacy deserts in the south west of England.

Pharmacies play a vital role in our healthcare system, and the Government recognises the integral role they play within our communities, as an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.Community pharmacies are private businesses that provide NHS funded services. Most pharmacies are not directly commissioned or contracted by the NHS, instead contractors apply to gain entry to the NHS pharmaceutical list and if an application is approved, a pharmacy can open and start providing services.Local authorities are required to undertake a pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served by local pharmacies, and must keep these assessments under review. Integrated care boards (ICBs) give regard to the PNAs when reviewing applications from new contractors. Contractors can also apply to open a new pharmacy to offer benefits to patients that were not foreseen by the PNA. If there is a need for a new local pharmacy to open and no contractors apply to open a pharmacy and fill the gap, ICBs can commission a new pharmacy to open outside of the market entry processes and fund the contract from the ICBs’ budgets.The Pharmacy Access Scheme helps protect access to pharmacies in areas where there are fewer pharmacies and higher health needs, so that no area is left without access to local, physical NHS pharmaceutical services.In general, despite a reduction in the number of pharmacies in recent years, patient access to pharmacies remains good, and continues to be better in the most deprived areas when compared with the least deprived.