Written questions by Green.

With reference to his strategy for NHS workforce planning, if he will make an assessment of the potential impact of shortages in the number of clinicians specialising in neurology on the adequacy of care for patients with (a) Parkinson's Disease and (b) other neurological conditions.

Currently, there are no specific plans to make an assessment of the potential impact of shortages in the number of clinicians specialising in neurology on the adequacy of care for patients with Parkinson's disease or other neurological conditions.As of July 2024, there were over 1,800 full-time equivalent (FTE) doctors working in the specialty of neurology in National Health Service trusts and other organisations in England. This includes over 900 FTE consultant neurologists. In 2023, the fill rate for recruitment into the specialty of neurology in England was 94%.The NHS workforce has been overworked for years, leading to staff becoming burnt out and demoralised. We must be honest about the challenges we are facing. The NHS is broken but not beaten and together we will turn it around.We have launched a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts needed, to move healthcare from hospital to the community, from analogue to digital, and from treatment to prevention. A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.There are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the Neurology Transformation Programme (NTP).The GIRFT National Specialty Report made recommendations designed to improve services nationally and to support the NHS to deliver care more equitably across the country. In addition, the NTP has developed a model of integrated care for neurology services to support integrated care boards to deliver the right service, at the right time for all neurology patients, including providing care closer to home.

What steps his Department is taking to promote awareness of early symptoms of Parkinson's disease amongst GPs.

General practitioners (GPs) are responsible for ensuring their own clinical knowledge, including of Parkinson’s disease, remains up-to-date, and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence, to ensure that they can continue to provide high quality care to all patients. All doctors registered in the United Kingdom are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. In 2012, the GMC introduced revalidation, which supports doctors in regularly reflecting on how they can develop or improve their practice, giving patients confidence that doctors are up to date with their practice, and promoting improved quality of care by driving improvements in clinical governance.The training curricula for postgraduate trainee doctors, set by the Royal College of General Practitioners, has to meet the standards set by the GMC. Whilst curricula do not necessarily highlight specific conditions for doctors to be aware of, they do emphasise the skills and approaches that a doctor must develop to ensure accurate and timely diagnoses and treatment plans for their patients.

What funding the Government provides for research into a cure for Parkinson's disease.

The Government’s responsibility for delivering Parkinson’s disease research is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research (NIHR), and the Department of Science, Innovation and Technology, with research delivered via UK Research and Innovation. The Government spent a total of £79.06 million on research into Parkinson’s disease between the financial years 2019/20 and 2023/24.As well as funding research itself, the NIHR invests significantly in research expertise and capacity, specialist facilities, support services, and collaborations to support and deliver research in England. Collectively, this forms the NIHR’s infrastructure. The NIHR’s infrastructure enables the country’s leading experts to develop and deliver high-quality translational, clinical, and applied research into Parkinson’s disease. For example, in the financial year 2022/23, the NIHR Clinical Research Network enabled 114 studies related to Parkinson’s disease.

What data his Department currently holds on waiting lists for treatment for Parkinson's Disease in England.

The Department does not hold data specifically on the number of people waiting for treatment for Parkinson’s disease in England. The Department does hold data on waiting times for neurology, but not broken down by specific conditions. The latest data for referral to treatment waiting times in England, from September 2024, shows there were over 234,000 patients waiting for a neurology appointment, and that 54% of patients were seen by a neurologist within 18 weeks.There are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the Neurology Transformation Programme (NTP).The GIRFT National Specialty Report made recommendations designed to improve services nationally, and to support the National Health Service to deliver care more equitably across the country. The report highlighted differences in how services are delivered, and provided the opportunity to share successful initiatives between trusts to improve patient services nationally. In addition, the NTP has developed a model of integrated care for neurology services to support integrated care boards to deliver the right service, at the right time for all neurology patients, including providing care closer to home.Once diagnosed, and with a management strategy in place, the majority of people with Parkinson’s can be cared for through routine access to primary and secondary care. NHS England commissions the specialised elements of Parkinson’s care that patients may receive from 27 neurology centres across England. Within specialised centres, neurological multidisciplinary teams ensure patients can access a range of health professionals, including Parkinson’s disease nurses, psychologists, and allied health professionals such as dieticians and speech and language therapists, and that they can receive specialised treatment and support according to their needs.No specific assessment has been made of the number of specialist Parkinson’s nurses required to meet the current need of patients in England. While the Department does not hold data specifically on the number of Parkinson’s specialist staff in England, we do hold data on the numbers working in the wider speciality of neurology. As of July 2024, there were over 1,800 full-time equivalent (FTE) doctors working in the specialty of neurology in NHS trusts and other organisations in England. This includes over 900 FTE consultant neurologists. In 2023, the fill rate for recruitment into the specialty of neurology in England was 94%.The NHS workforce has been overworked for years, leading to staff becoming burnt out and demoralised. We must be honest about the challenges we are facing. The NHS is broken but not beaten and together we will turn it around.We have launched a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, from analogue to digital, and from treatment to prevention.A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

What assessment he has made of the number of specialist Parkinson's Nurses required to meet the current needs of patients.

The Department does not hold data specifically on the number of people waiting for treatment for Parkinson’s disease in England. The Department does hold data on waiting times for neurology, but not broken down by specific conditions. The latest data for referral to treatment waiting times in England, from September 2024, shows there were over 234,000 patients waiting for a neurology appointment, and that 54% of patients were seen by a neurologist within 18 weeks.There are a number of initiatives supporting service improvement and better care for patients with Parkinson’s disease in England, including the Getting It Right First Time (GIRFT) Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the Neurology Transformation Programme (NTP).The GIRFT National Specialty Report made recommendations designed to improve services nationally, and to support the National Health Service to deliver care more equitably across the country. The report highlighted differences in how services are delivered, and provided the opportunity to share successful initiatives between trusts to improve patient services nationally. In addition, the NTP has developed a model of integrated care for neurology services to support integrated care boards to deliver the right service, at the right time for all neurology patients, including providing care closer to home.Once diagnosed, and with a management strategy in place, the majority of people with Parkinson’s can be cared for through routine access to primary and secondary care. NHS England commissions the specialised elements of Parkinson’s care that patients may receive from 27 neurology centres across England. Within specialised centres, neurological multidisciplinary teams ensure patients can access a range of health professionals, including Parkinson’s disease nurses, psychologists, and allied health professionals such as dieticians and speech and language therapists, and that they can receive specialised treatment and support according to their needs.No specific assessment has been made of the number of specialist Parkinson’s nurses required to meet the current need of patients in England. While the Department does not hold data specifically on the number of Parkinson’s specialist staff in England, we do hold data on the numbers working in the wider speciality of neurology. As of July 2024, there were over 1,800 full-time equivalent (FTE) doctors working in the specialty of neurology in NHS trusts and other organisations in England. This includes over 900 FTE consultant neurologists. In 2023, the fill rate for recruitment into the specialty of neurology in England was 94%.The NHS workforce has been overworked for years, leading to staff becoming burnt out and demoralised. We must be honest about the challenges we are facing. The NHS is broken but not beaten and together we will turn it around.We have launched a 10-Year Health Plan to reform the NHS. The plan will set out a bold agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, from analogue to digital, and from treatment to prevention.A central and core part of the 10-Year Health Plan will be our workforce and how we ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities.

What steps his Department is taking to help improve the treatment of long covid in the NHS.

Since 2020, the National Health Service in England has invested significantly in supporting people with long COVID. This includes setting up specialist post-COVID services nationwide for adults, and children and young people, as well as investing in ensuring general practice (GP) teams are equipped to support people affected by the condition.As of 1 April 2024, there are over 90 adult post-COVID services across England, along with an additional 10 children and young people’s hubs. These services assess people with long COVID and direct them into care pathways which provide appropriate support and treatment. GPs will assess patients that have COVID-19 symptoms lasting longer than four weeks, and refer them into a long COVID service where appropriate. Referral should be via a single point of access, which is managed by clinician-led triage.The Government has invested £58 million in research through two specific funding calls to better understand long COVID and how to treat it. The projects funded aim to improve our understanding of the diagnosis and underlying mechanisms of the disease and the effectiveness of both pharmacological and non-pharmacological therapies and interventions, as well as to evaluate clinical care. The NHS and scientific community are working at pace to progress long COVID research.

What steps his Department is taking to reduce risks to patient safety from the use of online consultation tools in general practice.

Although patient safety incidents related to online consultation tools are extremely rare, even a single incident is one too many, and the Government takes them very seriously. NHS England published the Primary Care Patient Safety Strategy (PCPSS) on 26 September 2024 which builds on the 2019 Patient Safety Strategy, and outlines how the National Health Service will continue to enhance patient safety in primary care.Commissioners and primary care providers can purchase digital tools from approved suppliers in the Digital Care Services catalogue. These suppliers must ensure they show compliance with clinical risk management standards. Integrated care boards should involve general practice staff and patients in the procurement process, and provide support for safe and effective tool implementation. Only services that meet required standards, including patient safety, can be procured. The PCPSS sets out additional safety requirements for suppliers to meet in future procurements.

If he will make an assessment of the potential implications for his policies of the recommendations contained in the Health Services Safety Investigations Body's report entitled Digital tools for online consultation in general practice.

While patient safety incidents related to online consultation tools are very rare, even one is too many, and the Government takes these very seriously. NHS England produced guidance on the implementation of digital services in May 2024. The guidance provides key rules to help guide practices on how best to implement services to reduce risks and improve patient safety, in line with the recommendations made in the Health Services Safety Investigations Body's (HSSIBs) report. The Government welcomes the HSSIB’s work to support patient safety in primary care.

What steps his Department is taking to help increase public awareness of the symptoms of thoracic endometriosis.

The Government recognises the significant challenges faced by women with endometriosis, and is committed to prioritising women’s health as we reform the National Health Service. Information for the public on endometriosis symptoms and treatments can be found on the NHS YouTube channel and the NHS website, which are available, respectively, at the following two links:https://www.youtube.com/watch?v=ABi1ncHorBYhttps://www.nhs.uk/conditions/endometriosis/Although at present thoracic endometriosis is not specifically mentioned on these pages, the NHS website’s endometriosis page links to further resources, including the Endometriosis UK website. The Endometriosis UK website includes information on endometriosis outside the pelvis and highlights questions that a patient can ask in secondary care, as well as the option of referral for a second opinion. Further information is available at the following link:https://www.endometriosis-uk.org/getting-diagnosed-0The Endometriosis UK website also includes an informational video on thoracic endometriosis, which is available at the following link:https://www.endometriosis-uk.org/webinar/thoracic-endometriosis

What steps his Department is taking to strengthen the enforcement of no smoking policies on NHS hospital grounds in England.

Smoking has been prohibited by law in virtually all enclosed and substantially enclosed workplaces and public places, including hospital buildings, throughout the United Kingdom since July 2007. Smoke-free legislation in England forms part of the Health Act 2006 and The Children and Families Act 2014.Enforcement powers for smoke-free places are given to local authorities, who must identify appropriate officers to enforce smoke-free regulations. The most appropriate team for this will vary by local authority but powers are most commonly assigned to teams of officers covering environmental health, health and safety or a similar area.Smoke-free policies in National Health Service hospital grounds in England go beyond requirements by law and are developed and implemented by the local NHS trust.

If he will make an assessment of the potential merits of designating brain tumours as a clinical priority.

While the Department has not made a formal assessment, it spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer the largest area of spend at over £121.8 million in 2022/23 reflecting its high priority. In September 2024, the NIHR announced new research funding opportunities for brain cancer research spanning both adult and paediatric populations. This includes a national NIHR Brain Tumour Research Consortium, to ensure the most promising research opportunities are made available to adult and child patients and a new funding call to generate high quality evidence in brain tumour care, support and rehabilitation.We will get the National Health Service diagnosing cancer, including brain tumours, on time, diagnosing it earlier and treating it faster so more patients survive this horrible set of diseases, and we will improve patients’ experience across the system. To do this, we 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.

What steps his Department is taking to support further research into levels of prostate cancer amongst black men.

Research is crucial in tackling cancer. The Department spends £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR), with cancer the largest area of spend at more than £121.8 million in 2022/23. NIHR spends more on cancer than any other disease group, reflecting its high priority.On 19 November 2023, the Government and Prostate Cancer UK announced a £42 million screening trial to find ways of detecting country’s most common male cancer earlier. Prostate Cancer UK is leading the development of the trial with the Government contributing £16 million through the Department.The TRANSFORM trial will aim to address some of the inequalities that exist in prostate cancer diagnosis today. For example, 1 in 4 black men will develop prostate cancer, double the risk of other men, and often at a younger age. Yet previous research has failed to involve and recruit enough black men and so has not been able to provide evidence needed to diagnose them earlier using a targeted approach. The TRANSFORM trial will ensure that at least 10% of the men who are invited to participate in the trial are black.

If he will make an assessment of the potential merits of extending free NHS prescriptions to people with Parkinson's disease.

There are no current plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. Approximately 89% of prescription items are dispensed free of charge in the community in England, and there are a wide range of exemptions from prescription charges already in place, for which those with Parkinson’s disease may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.People on low incomes can apply for help with their health costs through the NHS Low Income Scheme. Prescription prepayment certificates (PPCs) are also available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three-month and 12-month certificates available. The 12-month PPC can be paid for in instalments.