Written questions by Gibson.

For what reason accessible versions of the Pathways to Work Green Paper were not published at the same time as the original version; and if she will take steps to ensure that accessible versions of documents are published simultaneously in the future.

A full suite of accessible versions were published on 7 April, including web-accessible HTML versions, Large Print, Audio, British Sign Language, Braille and Easy Read. The consultation period closes on the 30 June 2025, allowing for a full twelve weeks after all the accessible versions were released to en-sure all stakeholders have sufficient time to engage. We published the Green Paper ahead of some accessible versions to put detailed information about the matters subject to consultation in the public domain at the earliest opportunity. The production of accessible versions to a high standard requires additional time.

If she will make an assessment of the potential impact of the eligibility criteria for Universal Credit on (a) young adults under 25 and (b) young adults under 25 who are (i) living independently and (ii) without family support in Wiltshire.

There are currently no plans to make such an assessment. To be eligible for Universal Credit a person is usually required to be at least 18 years old but there are circumstances where those aged 16 and 17 may be eligible to claim Universal Credit in their own right, including if they have no parent or cannot live with their parent(s). Young people under 25 who live independently may also be able to get help with their housing costs. DWP currently provides young people aged 16-24 with labour market support through an extensive range of interventions at a national and local level. This includes flexible provision driven by local need, nationwide employment programmes and support delivered by work coaches based in our Jobcentres and in local communities working alongside partners. All jobcentres deliver the Youth Offer and have Youth Employability Coaches in post to support young people aged 18-24 years old. Youth Hubs are currently being explored and are in the planning phase by both Swindon Borough Council and Wiltshire Council.

What steps his Department is taking to support the (a) development and (b) implementation of (i) whole genome sequencing and (ii) other innovative treatments for brain tumours.

We are supporting NHS England in implementing genomic testing, including whole genome sequencing (WGS), in the National Health Service, provided through the NHS Genomic Medicine Service, and delivered by a national genomic testing network of seven NHS Genomic Laboratory Hubs (GLHs). The NHS GLHs deliver testing as directed by the National Genomic Test Directory, which includes tests for over 200 cancer clinical indications, including WGS tests for a range of brain tumours.The NHS now offers all children and young people with cancer and adults with certain cancers, including brain cancer, whole genome sequencing to enable more comprehensive and precise diagnosis, and access to more personalised treatments.We recognise that there are currently limited treatment options available for people who have been diagnosed with brain tumours, and the significant impact that rarer forms of cancer can have on patients, carers, and their families. We are invested in driving new lifesaving and life-improving research, supporting those diagnosed and living with brain tumours.We are working on developing the National Cancer Plan, which will have patients at its heart and will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care. Research is a key focus of the plan, and we will work closely with partners, including the National Institute for Health and Care Research, on this.

What assessment she has made of the potential impact of the increase in employer National Insurance contributions on the VCSE sector.

In order to repair the public finances and help raise the revenue required to increase funding for public services, the government has taken the difficult decision to increase employer National Insurance contributions (NICs).A Tax Information and Impact Note (TIIN) was published alongside the introduction of the Bill containing the changes to employer NICs. The TIIN sets out the impact of the policy on the exchequer, the economic impacts of the policy, and the impacts on individuals, businesses, and civil society organisations as well as an overview of the equality impacts.The Government has protected the smallest businesses and charities from the impact of the increase to Employer National Insurance by increasing the Employment Allowance from £5,000 to £10,500, which means that 865,000 employers will pay no NICs at all this year and more than half of employers will see no change or will gain overall from this package.More broadly, within the tax system, we provide support to charities through a range of reliefs and exemptions, including reliefs for charitable giving, with more than £6 billion in charitable reliefs provided to charities, CASCs and their donors in 2023 to 2024.

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 plans to consult stakeholders on (a) alignment with international reporting standards and (b) the potential impact on companies as part of the first two UK Sustainability Reporting Standards, expected in Q1 2025.

The Government will shortly publish a consultation covering the endorsement of International Sustainability Standards Board (ISSB) Standards. It will seek views on UK versions of the ISSB Standards, which will be known as UK Sustainability Reporting Standards, including on the costs and benefits of reporting against those Standards. The Government will take endorsement decisions later this year, following the consultation.

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/

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

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

Whether it is her policy to maintain the number of driving test centres in rural communities.

The Driver and Vehicle Standards Agency (DVSA) is committed to providing its customers, including those in rural areas, with the best service possible. DVSA continually reviews its estate to ensure it represents good value for money and is efficient.

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 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.