Written questions by Gibson.

What assessment she has made of the prevalence of cryptocurrency use in illicit finance; and what steps she is taking to reduce this activity.

Directed by the Economic Crime Plan 2 (and supported by an Economic Crime Levy funding) UK law enforcement is investing in improving both its capacity and capability to investigate the criminal use of cryptoassets. This includes:Investing in specialist capability in the NCA and partner agencies, including the recruitment of an additional 475 Financial Crime investigators (292 currently in post) and developing an improved crypto track and trace capability which will go live in December 2025.Funding public-private crypto collaboration teams in police forces and ROCUs through the Asset Recovery Incentivisation SchemeNew training and upskilling that has been rolled out to improve law enforcement officers’ understanding of cryptoassets, supported by the provision of specialist tooling (i.e. blockchain analytics tools).Building a new crypto-specific public/ private partnership within the existing Joint Money Laundering Taskforce structure in order to understand the threat and foment various joint initiatives (including around data sharing).Developing a multi-agency operational crypto cell to ensure that knowledge and abilities in investigating cryptoassets are pooled together, and that all available tools and powers and are exploited efficiently.Designing a system-wide strategy, with an accompanying roadmap of activities required to prevent and disrupt digital asset-enabled crime impacting the UK. The focus is on ensuring system co-ordination and collaboration, keeping the public / consumers safe, effectively disrupting criminals through robust enforcement and building global co-operation to effectively share information and gain a consistency in regulatory standards.

Innovation and Technology, what estimate he has made of the number of households without home internet access in Wiltshire; and what recent estimate his Department has made of levels of digital exclusion in (a) Wiltshire and (b) Chippenham constituency.

According to Ofcom’s Connected Nations 2025 Spring Update, in the Wiltshire local authority area, 104 premises had no mobile, fixed or wireless internet service provider coverage and in the Chippenham constituency, 14 premises. And through Project Gigabit and the Shared Rural Network, we are continuing to deliver broadband and mobile connectivity to hard-to-reach areas with limited or no coverage.Ofcom survey data shows that around 5% of households nationally do not have at home internet access, we do not have a more local breakdown of this figure.The Government published its Digital Inclusion Action Plan in February 2025, which outlines the first five actions we are taking over the next year to boost digital inclusion across the UK.

How many reports of fraud involving impersonation of government agencies targeting pensioners have been recorded in each of the last five years by region.

The Home Office collects data on the number of fraud and computer misuse cases reported to Action Fraud that have been recorded as crimes by the National Fraud Intelligence Bureau (NFIB). Information on the victims of these cases is not held.Action Fraud reports of fraud and computer misuse offences are published by the Office for National Statistics (ONS) quarterly in the Crime in England and Wales tables, which can be found at this link: https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/datasets/crimeinenglandandwalesappendixtables

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/

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 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 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.

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.

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.

What recent assessment she has made of the adequacy of support available through Access to Work for people with cystic fibrosis (a) with and (b) without (i) transport and (ii) rural connectivity barriers to employment in Wiltshire.

The Access to Work Scheme provides grant funding for workplace adjustments that go beyond an employer’s duty to provide reasonable adjustments under the Equality Act 2010. The Scheme can provide support for those in work or about to start work for a wide range of health conditions, such as Cystic Fibrosis, including support to travel to and in work.In 2018, the Department commissioned NatCen, an independent social research organisation, to explore the feasibility of evaluating the impacts of Access to Work. The report uncovered several challenges determining the impacts of Access to Work mainly around identifying an appropriate counterfactual and the difficulties in constructing a comparison group.To assess the role of Access to Work in supporting people with disabilities and long-term health conditions to enter and stay in work, the Department commissioned qualitative evaluations of Access to Work in most recently in 2018, and 2009. The 2018 evaluation ‘Access to Work: Qualitative research with applicants, employers and delivery staff’ gathered evidence on the value of Access to Work to employers and employees.The 2009 evaluation: ‘Evaluation of Access to Work: Core Evaluation’ explored customer, employer, assessor and other views relating to: marketing and awareness, application process, assessments, outcomes, impact and areas for improvement.

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.

Whether she plans to review the (a) guidance and (b) training provided to assessors conducting Work Capability Assessments for people living with ME.

When the FAS Health Assessment Advisory Service (HAAS) contracts commenced, DWP Clinical Policy Group took over ownership of all the clinical Core Training and Guidance Materials (CTGM). These documents, amongst other things, contain clinical condition specific training including ME. All HAAS Lot Suppliers are required to use CTGM to inform and develop training programmes and associated materials for their Health Care Professionals (HCPs) delivering Work Capability Assessments, Personal Independence Payment and Specialist benefit assessments on behalf of the DWP. HCPs are required to have appropriate knowledge of the clinical aspects and the functional effects of a wide range of health conditions and disabilities. To maintain quality and consistency across all Suppliers, we have established a Clinical Authorship Team (CAT), an Editorial Board and a robust quality assurance process. The CAT is responsible for producing, reviewing, and updating all CTGM annually. The CAT is comprised of: Clinical leads, Clinical authors & Admin leads from each of the Suppliers and is overseen by the DWP clinical policy team. To ensure CTGM is unbiased and fit for purpose it is subject to a rigorous quality assurance process. All materials are clinically quality assured by external independent clinicians (in line with best practice and current up-to-date clinical guidance e.g. NICE guidelines) and policy quality assured by DWP clinical policy experts.

How much funding has been allocated to post-16 skills and vocational training in Wiltshire since 2020.

The department publishes details of 16 to 19 Total Programme Funding allocations by academic year. These are available for each academic year since 2020, and can be accessed at the following pages:2020/21: https://www.gov.uk/government/publications/16-to-19-allocation-data-2020-to-2021-academic-year.2021/22: https://www.gov.uk/government/publications/16-to-19-allocation-data-2021-to-2022-academic-year.2022/23: https://www.gov.uk/government/publications/16-to-19-allocation-data-2022-to-2023-academic-year.2023/24: https://www.gov.uk/government/publications/16-to-19-allocation-data-2023-to-2024-academic-year.2024/25: https://www.gov.uk/government/publications/16-to-19-allocation-data-2024-to-2025.Each publication can be filtered by local authority to identify the funding for Wiltshire.Allocations for the Adult Skills Fund, formerly the Adult Education Budget, are also published annually, and can be accessed at: https://www.gov.uk/guidance/adult-education-and-skills-funding-allocations#published-allocations.Whilst they cannot be filtered by local authority, they can be filtered by individual provider.

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.

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.

How many patients have been prescribed stem cell transplantation therapy for MS in the last five years, by NHS region.

Whilst there is no data available for how many people with multiple sclerosis (MS) have been prescribed a stem cell transplant, the British Society for Blood and Marrow Transplant and Cellular Therapy (BSBMTCT) reports that, between 2018 and 2022, there were 232 autologous stem cell transplants performed for MS in England. There may be patients for whom a stem cell transplant was prescribed but they did not go ahead with the transplant.This data has not been made available to NHS England by BSBMTCT by National Health Service region.

If he will publish waiting times for ADHD assessment by region; and what steps he is taking to help Integrated Care Boards with the longest waits reduce those waiting times.

There is, at present, no single, established dataset that can be used to monitor waiting times for assessment and diagnosis for attention deficit hyperactivity disorder (ADHD) for individual organisations by regions in England. Although the data requested is not held centrally, it may be held locally by individual National Health Service trusts or commissioners.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 has also released technical guidance to integrated care boards (ICBs) to improve recording of ADHD data, with a view to improving the quality of ADHD waits data and publishing more localised data in future.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 report is expected to be published shortly, with the final report expected in the summer. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services and is using this information to support local systems to tackle ADHD waiting lists and provide support to address people’s needs.

What assessment he has made of the adequacy of the availability of high-efficacy treatments for relapsing-remitting MS on the NHS.

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether new medicines should be routinely funded by the NHS based on an assessment of their costs and benefits. The NHS in England is legally required to fund medicines recommended by NICE, which has recommended a number of new medicines for use in the treatment of relapsing-remitting multiple sclerosis (MS) that are now routinely available for use in the treatment of NHS patients.Most recently, in April 2025, NICE recommended cladribine for treating active relapsing-remitting forms of MS. In December 2024, NICE had already recommended ublituximab for treating relapsing-remitting MS.

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.

What recent assessment he has made of the effectiveness of the Orphan Drug Regulations in stimulating innovation in treatments for pancreatic cancer.

The Human Medicines Regulations include specific incentives to support orphan medicines, designed to encourage the development of medicines for rare diseases. The regulations enable the Medicines and Healthcare products Regulatory Agency (MHRA) to grant orphan designation to a medicine intended for the prevention, diagnosis, or treatment of a rare condition. This orphan designation provides the product with a period of market exclusivity for the specified condition, preventing similar competitor medicines from entering the market during this time. Pancreatic cancer can be considered as falling under the definition of the rare diseases. The MHRA further supports developers of orphan medicines by offering a full or partial refund of the marketing authorisation fee following a positive orphan designation. There is evidence that the regulations for orphan medicines do support development, with around 150 medicines successfully developed and authorised for the diagnosis, prevention and treatment of rare diseases and given a United Kingdom orphan designation. The MHRA will continue to review its approach to orphan medicines and, where necessary, propose updates to the criteria to further encourage research into rare diseases and improve patient outcomes.