Written questions by Hall.

With reference to the 10-Year Plan for Health, if he will publish further detail on proposals to increase the provision of palliative and end of life care in community settings.

One of the three ‘shifts’ that the 10 Year Health Plan will deliver is around the Government’s determination to shift healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting. Palliative care and end of life care services will have a big role to play in that shift and were highlighted in the plan as being an integral part of neighbourhood teams.I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care in line with the 10 Year Health Plan.Officials will present further proposals to ministers over the coming months, outlining the drivers and incentives that are required in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.To support integrated care boards (ICBs) in the commissioning of palliative care and end of life care services, NHS England has published statutory guidance and service specifications. The guidance makes specific reference to commissioners defining how their services will meet population needs 24/7 and includes a priority action for ensuring that staff, patients, and carers can access the care and advice they need, whatever time of day.National Institute for Health and Care Excellence (NICE) guidance on the service delivery of end of life care for adults also includes recommendations about 24/7 access to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.The Government and the National Health Service will closely monitor the shift towards the strategic commissioning of palliative care and end of life care services to help ensure that services remove variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.

Which hospitals will be investigated as part of the inquiry into maternity care in England.

The investigation will carry out rapid reviews of up to ten trusts with specific issues. The University Hospitals Sussex NHS Foundation Trust will be one of those trusts, as outlined on 23 June. The other trusts will be identified in due course.

If he will make an estimate of the number of people who have been admitted to hospital after losing their PIP in each month in the last three years.

The information requested is not collected centrally.

What steps his Department is taking to establish the National Care Service; and what his planned timeline is for (a) consultation with stakeholders and (b) implementation.

The Government has taken a critical first step towards a National Care Service by launching an independent commission into adult social care. The commission will build national consensus to create a National Care Service that is productive, preventative, and gives people who draw on care, and their families and carers, more power in the system. It will be for the independent commission to determine their approach, but we expect it will include engaging with a wide range of stakeholders, including people with lived experience and unpaid carers, as well as building cross-party consensus. Further details will be set out by the commission in due course. In the short-term, we are laying the foundations for a National Care Service by introducing legislation for the first ever Fair Pay Agreement for the care workforce, expanding the first-ever national career structure for the adult social care workforce, digitising care providers, and setting new standards for care technologies.

What recent steps his Department has taken to improve access to NHS dentistry in Warrington South constituency; and what plans he has to increase the number of NHS dentists practising in Warrington.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Warrington South constituency, this is the NHS Cheshire and Merseyside ICB.ICBs have been asked to start making extra urgent dental appointments available from April 2025. The NHS Cheshire and Merseyside ICB is expected to deliver 46,617 additional urgent dental appointments as part of the scheme.ICBs have started to recruit posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.

What recent assessment he has made of the (a) effectiveness and (b) value for money of modular hospital construction methods in delivering additional NHS capacity; and whether he has plans to increase the use of (i) modular and (ii) prefabricated buildings across the hospital estate.

We recognise the benefits and opportunities of modern methods of construction (MMC), including modular construction, faster construction times, cost savings, minimised disruption, higher quality and safety standards, and the use of sustainable materials and methods.A toolkit has been developed to support MMC opportunities in healthcare and is available at the following link:https://www.england.nhs.uk/long-read/nhs-modern-methods-of-construction-assessment-tool-user-guide/The NHS MMC assessment tool is recommended for use on all projects to inform the use of MMC of opportunities and is mandated for projects over £25 million to meet business case requirements of 70% new build and 50% refurbishment using MMC.The New Hospital Programme is already transforming the way that hospital infrastructure is constructed by using a national standardised approach, called Hospital 2.0. Hospital 2.0 uses a standardised ‘kit of parts’ for hospital components, ranging from doors to full bathroom pods, that can be assembled into different size hospitals in an optimised, consistent, and repeatable way and with off-site manufacturing and assembly, reducing costs and accelerating construction. Taken together, MMC and Hospital 2.0 will accelerate the building process, improving productivity and maximising value for money.

What steps he is taking to improve (a) waiting times and (b) access to phlebotomy services.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care.We also recognise that care, including phlebotomy, should be more easily accessible, and located in the community where possible, which is more convenient for patients than going to hospital.The Elective Reform Plan, published in January 2025, sets out the productivity and reform efforts needed to return to the 18-week constitutional standard by the end of this parliament. The plan commits to transform and expand diagnostic services and speed up waiting times for tests, a crucial part of reducing overall waiting times and returning to the RTT 18-week standard.Community diagnostic centres (CDCs) are supporting one of the Government’s top priorities for health, to shift care from the hospital to the community. CDCs offer local populations a wide range of diagnostic tests, including phlebotomy, closer to home and greater choice on where and how they are undertaken whilst also reducing pressure on hospitals. Latest management information data shows that CDCs have delivered over 3.7 million phlebotomy tests since July 2021.Healthcare services provided by general practice, including phlebotomy are commissioned locally by integrated care boards based on population need.

What steps his Department is taking to reduce regional disparities in the early diagnosis of liver (a) disease and (b) cancer; and if he will provide additional support to (a) the North West and (b) other high-incidence areas.

Early detection of liver disease and cancer is vital to enable interventions and encourage behavioural change that can potentially lead to recovery. Except for liver transplant services, which are commissioned by NHS England, the commissioning of services for diagnosing, monitoring and treating liver disease is generally the responsibility of integrated care systems (ICS). ICSs are responsible for decisions on commissioning health services and reviewing those services to ensure they best meet the needs of their local population.NHS Cheshire and Merseyside was one of the first integrated care boards in the country to mandate and support the formation of a Clinical Liver Network to improve liver health outcomes across the system. To improve the diagnosis of previously undiagnosed liver disease in non-traditional healthcare settings there is also a Community Liver Health Checks programme. This programme targets people from the most disadvantaged communities and since its inception in April 2023, this programme has delivered 8,564 scans across more than 50 individual sites across Cheshire and Merseyside.Reducing inequalities is a priority for the forthcoming National Cancer Plan, which will look at the targeted improvements needed across different cancer types to reduce disparities in cancer survival and develop interventions to tackle these. The National Cancer Plan will include further details on improving outcomes for cancer patients, including those with liver cancer, and will highlight how the Department will support the National Health Service to improve diagnosis rates for people in all parts of England. This includes looking at inequalities related to geographic location.For the first time ever, cancer survival rates in Cheshire and Merseyside have risen above the all-England average. This is largely due to a combination of targeted work, and a step-change in access to early diagnosis supported by a growing network of community diagnostic centres.

If he will make it his policy that all eligible patients with SOD1-related Motor Neurone Disease can access Tofersen.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. The NHS in England is legally required to fund medicines recommended by NICE, normally within three months of the publication of final guidance.NICE has selected tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations as a topic for guidance development through its Highly Specialised Technology (HST) programme. The HST programme appraises medicines for the treatment of very rare, and often very severe diseases, and evaluates whether they can be considered a clinically and cost-effective use of NHS resources.

What steps he is taking to ensure his Department's work on reducing suicide rates includes measures to help those that have been reported missing.

The actions set out in the National Suicide Prevention Strategy for England will apply to missing people where relevant. However, we are not taking any specific actions targeted at measuring and reducing suicide rates among people reported missing. As part of our mission to build a National Health Service fit for the future, we are committed to tackling suicides as one of the biggest killers, working closely with other government departments and agencies.

What steps his Department is taking to monitor the correlation between trends in the number of people (a) going missing and (b) committing suicide.

The actions set out in the National Suicide Prevention Strategy for England will apply to missing people where relevant. However, we are not taking any specific actions targeted at measuring and reducing suicide rates among people reported missing. As part of our mission to build a National Health Service fit for the future, we are committed to tackling suicides as one of the biggest killers, working closely with other government departments and agencies.

What assessment he has made of the potential implications for his policies of the Alzheimer’s Society’s report entitled Because we’re human too: Why dementia training for care workers matters, and how to deliver it, published on 13 November 2024; and if he will make it his policy that adult social care staff should have mandatory dementia training.

The Department welcomes knowledge sharing across the sector and officials will consider the report in future policy development. Under the Health and Social Care Act 2008, care providers are required to provide sufficient numbers of suitably qualified, competent, skilled, and experienced staff to meet the needs of the people using the service. We now have a national career framework for adult social care, the Care Workforce Pathway, which is linked to several existing competency frameworks, including the dementia training standards framework. The Department developed the pathway in partnership with Skills for Care, representatives from the adult social care workforce, and people who draw on care and support. The Department has also launched a new Level 2 Adult Social Care Certificate qualification which links to outcomes in the Care Workforce Pathway. This contains the baseline knowledge required to provide quality care and will make sure that those who are starting out their careers in care have an informed awareness of dementia.

What steps his Department is taking to ensure that NHS mental health services do not exclude anyone because of a neurological diagnosis.

Access to National Health Service mental health services is based on clinical need, including for patients with a neurological diagnosis.More broadly, we know that too many people with mental health issues are not getting the support or care they need, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health, and that people, including those with a neurological diagnosis, can be confident in accessing high quality mental health support when they need it.

What steps his Department is taking to ensure that people with Huntington’s disease have a named health professional who can coordinate their care.

NHS England specialised commissioning does not centrally commission dedicated care co-ordinators for Huntington’s Disease within integrated care boards (ICBs). ICBs are responsible for working with their local communities to understand the needs of the local populations and make decisions about how best to commission services that meet those needs, including the treatment of Huntington’s Disease, in partnership with other local commissioners and organisations.Steps are being taken to improve coordination of care for all rare diseases as a priority under the UK Rare Diseases Framework. England’s Rare Diseases Action Plans detail a range of measures to improve coordination of care. NHS England committed to include the definition of coordination of care in all new and revised services specifications for patients with rare diseases. All highly specialised centres are required to work collaboratively with other providers in the service and have shared care arrangements in place with local hospitals as required. The National Institute of Health and Care Research has commissioned research to provide the evidence needed to operationalise better co-ordination of care for rare diseases in the National Health Service.

What discussions (a) he and (b) his officials have had with the hospice and end of life care sector on future funding for the sector.

I have met with NHS England to discuss how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. I also recently met Together for Short Lives and one of the chairs of the Children Who Need Palliative Care All Party Parliamentary Group to discuss children’s palliative and end of life care, and funding was discussed at length at this meeting.Department officials meet regularly with palliative and end of life care stakeholders, including Hospice UK, Sue Ryder, Marie Curie, and Together for Short Lives. We, alongside key partners NHS England, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face. We will consider next steps on palliative and end of life care, including funding, in the coming months.Additionally, we have committed to develop a 10-year plan to deliver a National Health Service fit for the future, by driving three shifts in the way health care is delivered. We will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders as we develop the plan. More information about how to input into the 10-Year Health Plan is available at the following link:https://change.nhs.uk/en-GB/We have been actively encouraging our stakeholders to engage with that process to allow us to fully understand what improvements could be made.

Whether he plans to standardise data systems for prescriptions between (a) health authority areas, (b) the NHS and (c) GP community services.

Approximately 95% of all primary care prescriptions are standardised using the Electronic Prescription Service (EPS). The EPS allows prescribers to send prescriptions electronically to a dispenser, such as a pharmacy, nominated by the patient. This makes the prescribing and dispensing process more efficient and convenient for patients and healthcare workers. The EPS is a national service and transcends health authority or integrated care board boundaries, because a prescriber using the EPS can prescribe a prescription that can be dispensed in any pharmacy in England. The EPS can also be used by prescribers in urgent and emergency care, using the NHS 111 or 111 Online services.The Digital Medicines programme is introducing this capability for secondary care, specifically acute and community hospital trusts and mental health trusts, so National Health Service trusts can implement and use EPS, where clinically and legally appropriate, meaning patients treated in secondary care settings will also be able to receive their medicines from any dispensary in England.

If he will update the NHS website to include (a) hyperinsulinism amongst rare diseases and (b) what to do should you or someone you know exhibit symptoms of hyperinsulinism.

There are no current plans to update the National Health Service website to include information on hyperinsulinism. There are over 7,000 rare diseases often needing highly specialised input, and so the NHS website is not always the most appropriate platform to disseminate such information.Congenital hyperinsulinism (CHI) is a rare and complex condition requiring specialised care through a multidisciplinary team led by an expert paediatric endocrinology service. CHI is present from birth, and a child usually starts to show symptoms within the first few days of life, although very occasionally symptoms may appear later in infancy. These patients may not be picked up in hospital after birth and will present often to their midwife or general practitioner with symptoms, and require referral to specialist care later on in infancy. Symptoms can include floppiness, shakiness, poor feeding, sleepiness, and seizures. It is important that anyone who is worried their child may be exhibiting these symptoms seeks urgent medical advice. Ideally, children with suspected CHI should be transferred to a specialist centre.NHS England commissions this highly specialised service for CHI from three units: Great Ormond Street Hospital for Children; Royal Manchester Children’s Hospital; and Alder Hey Children’s Hospital.

What information his Department holds on the number of prisoners diagnosed with Huntington's disease in the last five years.

Neither the Department nor NHS England holds the information requested centrally.

If he will make an assessment of the potential merits of introducing a Vape Licensing Scheme.

The Government is concerned about the access of vapes to children, with a quarter of children aged between 11 and 15 years old having ever tried vaping in 2023, and acknowledges that a licensing scheme for the retail sale of vapes could help to strengthen enforcement and support legitimate businesses.The Government will soon introduce the Tobacco and Vapes Bill which stands to be the most significant public health intervention in a generation. The Bill will put us on track to a smoke-free United Kingdom, helping to reduce 80,000 preventable deaths each year, reduce the burden on the National Health Service and reduce the burden on the taxpayer.We will set out more details soon.