Written questions by Raja.

Whether his Department has completed an impact assessment and cost-benefit analysis of the proposed reforms to NHS England; and if so, when it will be published.

Work is progressing at pace to develop the design and operating model for the new integrated organisation, and plan for the smooth transfer of people, functions and responsibilities.It is only right that with such significant reform, we commit to carefully assessing and understanding the potential impacts, as is due process. These ongoing assessments will inform our programme as appropriate.We are committed to transparency and will ensure that, following necessary appraisal, all relevant information is made accessible to Parliament. This includes the Impact Assessment that will accompany the primary legislation. Subject to the will of Parliament, the passage of the Bill is expected by March 2027.

What steps his Department is taking to ensure that local NHS commissioning decisions use spare capacity in the independent sector to reduce NHS waiting lists.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.Fit for the Future: The 10-Year Health Plan for England and the Partnership Agreement between NHS England and the Independent Healthcare Providers Network reaffirmed our continued commitment to using independent sector capacity to improve access, reduce backlogs, and build a sustainable healthcare system.Between April 2025 and November 2025, the latest month for which data is available, over 1.1 million pathways have been taken off the waiting list by independent sector providers, with independent sector providers delivering 9.9% of all elective ordinary and day case procedures for the National Health Service.Commissioning decisions are for integrated care boards to make, who have a duty to arrange health services for the patients they are responsible for while living within their financial allocations. We expect decisions by local systems to support efforts achieving the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26. NHS England has clearly set out that any decision to set activity management plans must not in any way restrict patient choice of provider.

What estimate he has made of the savings generated by reductions in NHS England staffing; and how are those savings being redirected into frontline patient care.

Creating a new joint organisation will streamline decision-making, reduce bureaucracy, and improve accountability. These changes are expected to generate significant efficiencies over time.The Department’s initial modelling demonstrate that the up-front investment in organisational change will be offset by long-term reductions in staffing and running costs, ensuring the programme delivers value for money and sustainable savings for the taxpayer. Current estimates expect that these changes will save £1 billion a year by the end of this Parliament, which is equivalent to 116,000 hip and knee operations.The Government is committed to transparency in how these figures are calculated. The methodology underpinning the £1 billion saving estimate will be set out through established mechanisms, including publication of supporting documentation where appropriate. This will ensure that both Parliament and the public are able to scrutinise the basis of the savings. Further detail will be brought forward over time, in line with our commitment to provide clear and timely information.The Department is committed to transparent, responsible, evidence-based policy making. We will publish proportionate assessments to support reforms. Assessments will be published to enable scrutiny and will be proportionate to the scale of reform.

I) what metrics his Department will use, and ii) over what timeframe, to judge whether the reforms to NHS England deliver (a) improved productivity, (b) reduced bureaucracy, and (c) better patient outcomes.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, has set out his objectives for the wider health and care system through the 10-Year Health Plan which sets ambitious targets for the wider health and care sector to deliver the three big shifts: from hospital to community; from analogue to digital; and from sickness to prevention. The reforms to NHS England, and the wider health and care landscape, are a key component in delivering on this vision for a transformed National Health Service. As such, these reforms will be primarily judged and assessed against the extensive targets set out in this plan. Further information on the plan is available at the following link:https://assets.publishing.service.gov.uk/media/6888a0b1a11f859994409147/fit-for-the-future-10-year-health-plan-for-england.pdfWork is also continuing at pace to develop specific metrics and targets for the new Department of Health and Social Care that is being created. As is the case for any Government department, we will also develop specific metrics and targets for the new Department of Health and Social Care, which will be shared with Parliament and published.

What steps his Department is taking following the closure of NHS Commissioning Support Units to (a) support staff affected, and (b) ensure that functions previously delivered by those units continue to be provided safely and effectively.

As integrated care boards (ICBs) develop their strategic commissioning role and skills, commissioning support functions will be rationalised. This will result in commissioning support units (CSUs) being closed.Given wider changes in the system, including the larger geographical area of ICBs and the move to a more simplified operating model, for the National Health Service a whole, it is logical to integrate the work undertaken by CSUs into the other organisations that will make up the more streamlined, efficient NHS in future. The closure of CSUs will simplify the landscape and create efficiencies, and will strengthen the strategic commissioning skills in ICBs by giving them the freedom to develop these.A plan has been developed to ensure all services provided by CSUs and all CSU staff are mapped and destinations clarified, where function will continue, and workshops have been held with NHS England Regions to understand ICB intentions and timelines for the transfer of functions and staff and with the Department and NHS England on functions that may form part of the new Department. Governance arrangements are in place across NHS England and the CSUs to oversee the transition of functions and the safe closure of CSUs.Staff are being supported through this transition. The CSU Leadership Team hold regular all staff briefings where information on the abolition is cascaded. The CSUs are actively involving the trade unions. A voluntary redundancy scheme has been launched within the CSUs that mirrors that within NHS England. Staff are being actively informed about the scheme through the all-staff briefings.

What assessment the Department has made of the potential impact of reducing NHS-funded activity delivered by independent sector providers on local waiting times in (a) Leicester, (b) The East Midlands and (c) England.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to putting patients first by ensuring that they are seen on time and that they have the best possible experience of care. Since the Government came into office, the waiting list for routine appointments, operations, and procedures in England has now been cut by 312,369. This is despite 30.1 million referrals onto the waiting list.

If he will take steps to review NHS communications to ensure that language on (a) pregnancy and (b) breast feeding reflects biological sexes.

We are committed to working with NHS England to ensure health communications are as clear as possible and appropriately reflect sex as a protected characteristic in the Equality Act 2010. This includes communications about pregnancy and breast feeding. In April, in its judgment in the case of For Women Scotland Ltd v. The Scottish Ministers, the Supreme Court announced that it had reached a unanimous decision that the terms ‘man’, ‘woman’, and ‘sex’ in the Equality Act 2010 refer to biological sex. We welcome the clarity this brings. We recognise that there will be occasions when National Health Service providers want to specifically acknowledge patients with differing characteristics, including the transgender community. This may mean that trusts and providers decide to use additive language, for example “women and trans men”, to ensure health communications reach the largest audience.

If he will make an assessment of the potential merits of replacing the lifetime blood donation deferral for people who have used tanning injections with a fixed-term exclusion period similar to those in place for (a) tattoos and (b) piercings.

There are no plans to update the deferral policy for tanning injections. Unlike tattooing and piercing, tanning injections are not well regulated. Given injectable tanning products work internally, they do not meet the definition of a cosmetic product and are therefore not regulated via the UK Cosmetic Regulation. Regulation ensures safety standards are maintained to reduce the risk of transmitting a blood-borne infection.To protect the safety of the patient who receives the blood donation, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use, as per the Blood Safety and Quality Regulations 2005, with further information available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3

When his Department last reviewed NHS Blood and Transplant’s donor eligibility policy on the use of unlicensed injectable substances.

The safety of blood is of the upmost importance. The Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use, with further information available in the Blood Safety and Quality Regulations 2005, at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3The Advisory Committee on the Safety of Blood, Tissues and Organs, which provides expert advice to all the United Kingdom’s governments, conducted a full review of the donor selection criteria in 2017. This includes the use of unlicensed injectable substances.The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee provides expert guidance to the UK blood services. Their Whole Blood and Component Donor Selection Guidelines, which includes the guidance relating to injectable tanning agents, were last updated on 18 July 2025.

What steps his Department is taking to ensure that NHS Blood and Transplant donor exclusion policies (a) reflect up-to-date medical evidence and (b) do not unnecessarily restrict donor participation.

NHS Blood and Transplant’s (NHSBT) donor selection criteria are based on advice provided by the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee (JPAC). JPAC regularly reviews its guidelines to reflect the latest evidence. Their Whole Blood and Component Donor Selection Guidelines were last updated on 18 July 2025.Based on the recommendations of the For the Assessment of Individualised Risk Steering Group, the Government updated the blood donor selection criteria in 2021, thereby providing more opportunities for people to give blood.

For what reason people who have used tanning injections are permanently unable to donate blood.

The safety of blood is of the upmost importance. Patients that receive blood donations can be particularly vulnerable to infections. In the United Kingdom, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use. The Blood Safety and Quality Regulations 2005 are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3This is also reflected in the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) guidelines, the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryInjections can carry a risk of blood-borne illness. To preserve the safety of patients who receive blood donations, measures are taken to reduce the risk of transmitting blood-borne infections, including cleanliness and safety standards. However, as tanning injections are not well regulated, measures that would normally be used to prevent blood-borne infection cannot be assessed.

Whether NHS Blood and Transplant has made an assessment of the potential impact of the use of tanning injections more than (a) 12 months (b) three months prior to donating on blood safety.

The safety of blood is of the upmost importance. Patients that receive blood donations can be particularly vulnerable to infections. In the United Kingdom, the Blood Safety and Quality Regulations 2005 mandate permanent deferral from blood donation for anyone with a history of non-prescribed intravenous or intramuscular drug use. The Blood Safety and Quality Regulations 2005 are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3This includes those in receipt of tanning injections, for any period prior to donation. NHS Blood and Transplant has provided guidance on blood safety by the Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC). JPAC guidance reflects the Blood Safety and Quality Regulations 2005 in the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryInjections can carry a risk of blood-borne illness. To preserve the safety of patients who receive blood donations, measures are taken to reduce the risk of transmitting blood-borne infections, including cleanliness and safety standards. However, as tanning injections are not well regulated, measures that would normally be used to prevent blood-borne infection cannot be assessed.

Whether the permanent exclusion of people who have used tanning injections is consistent with the current evidence base on the persistence of bloodborne infection risks.

The safety of blood is of the utmost importance. Donor exclusion policies are in place to maintain safety and are mandated in the Blood Safety and Quality Regulations 2005: The Blood Safety and Quality Regulations 2005, which are available at the following link:https://www.legislation.gov.uk/uksi/2005/50/schedule/part/3/paragraph/2n3Similarly to individuals with a history of Hepatitis B, Hepatitis C, and HIV, those with a history of non-prescribed intravenous or intramuscular drug use are permanently deferred from donating blood.The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services’ Professional Advisory Committee produces guidance documents for UK blood services which outline the risks posed by tanning injections in the Addiction and Drug Abuse guideline and the Blood Safety Entry guideline, which are available, respectively, at the following two links:https://transfusionguidelines.org/dsg/wb/guidelines/ad001-addiction-and-drug-abusehttps://www.transfusionguidelines.org/dsg/wb/guidelines/bl008-blood-safety-entryTheir Whole Blood and Component Donor Selection Guidelines, which includes the guidance relating to injectable tanning agents, were last updated on 18 July 2025.

Whether he plans to delegate the commissioning of vaccination and immunisation services to integrated care boards from April 2026.

I refer the Hon. Member to the answer I gave on 29 September 2025 to Question PQ76374.

Whether he has made an assessment of the potential impact of not referencing biological sexes in some maternity care guidance on the safeguarding of patients.

The Department’s longstanding position is that health information should be as clear as possible and language should be used that appropriately reflects sex as defined in the Equality Act 2010.National maternity guidance and key documents, such as the Three-Year Delivery Plan for Maternity and Neonatal Services, reference women throughout.

Whether his Department has allocated funding to (a) initiatives and (b) organisations that promote the use of the term chestfeeding.

The Department funds infant feeding services and support through the National Health Service, local authorities, and the National Breastfeeding Helpline.We want all families to be able to achieve their infant feeding goals, regardless of their circumstances, and infant feeding support and advice should be available to anyone who needs it.

With reference to Together for Short Lives’ report entitled Overstretched and Underfunded: The State of Children’s Hospice Funding in 2025, what assessment he has made of the potential impact of cuts to ringfenced NHS funding for children's hospices beyond 2025-26 on the adequacy of (a) end of life care, (b) respite support and (c) other essential services.

Children and young people’s hospices do incredible work to support seriously ill children and their families and loved ones when they need it most, and we recognise the incredibly tough pressures they are facing.We are providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which, until recently, was known as the Children’s Hospice Grant.I can also now confirm the continuation of this vital funding for the three years of the next spending review period, 2026/27 to 2028/29 inclusive. This funding will see circa £26 million, adjusted for inflation, allocated to children’s and young people’s hospices in England each year, via their local ICBs on behalf of NHS England, as happened in 2024/25 and 2025/26. This amounts to approximately £80 million over the next three years.This revenue funding is intended to be spent by hospices to provide high-quality care and support for the children and the families they care for, either in the hospice or in the community, including in children's homes. They can, for example, use this funding for providing respite care for children who have high health needs, by providing physiotherapy or occupational therapy, or by providing 24/7 nursing support for a child at the end of their life.We are also supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.

What plans he has to reduce the variation in integrated care board (ICB) funding for children's hospices; and if he will commit to holding ICBs to account for the way in which they (a) commission children's palliative care and (b) comply with their legal duties in this area.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Service services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative care and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure that they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I can also now confirm the continuation of this vital funding for the three years of the next spending review period, 2026/27 to 2028/29 inclusive. This funding will see circa £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local ICBs on behalf of NHS England, as happened in 2024/25 and 2025/26. This amounts to approximately £80 million over the next three years.The Department and NHS England are currently looking at how to improve the access, quality and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.We will closely monitor the shift towards strategic commissioning of palliative and end of life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.On ICB accountability, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.

What steps (a) his Department and (b) the NHS are taking to counter (i) misinformation and (ii) disinformation about vaccines.

The Government is committed to tackling vaccine misinformation, and we have highlighted our focus on this within the 10-Year Health Plan where we have committed to working with local government, civil society, voluntary organisations and community groups to support public trust in vaccines, particularly in terms of what is needed to restore childhood immunisations rates.Inaccurate information can spread easily, particularly on online platforms, and it is important that we continue to robustly counteract mis and dis information and point to science. The UK Health Security Agency (UKHSA) closely monitors online activity, including social media and search data, to gather insights about the conversations people are having about vaccinations online, to help inform the information we provide and communications campaigns.The Department and its partners, take a broad multi-pronged approach to provide authoritative, accurate and transparent information on the benefits and risks of vaccination. For example, UKHSA and NHS England are working to ensure that health care professionals are adequately briefed and trained, with UKHSA recently updating its National Minimum Standards and core curriculum for vaccine training, published in June 2025, which set out expectations for training and competency requirements for all those delivering immunisation services.Additionally, the Department is working with UKHSA and the National Health Service to ensure that parents and patients have access to up to date and accurate information on all vaccines delivered by the NHS, and to identify and rebut false information. This includes information leaflets and promotional materials available online about different vaccination programmes, covered in a range of translations and accessible formats. Vaccination is also included in the latest Relationships, Sex and Health Education curriculum guidance from July 2025 to ensure that young people learn the facts and scientific evidence relating to vaccination and immunisation.Furthermore, the Department, UKHSA and NHS England are also delivering national communication campaigns which proactively highlight the value of vaccines and the risks associated with vaccine preventable diseases, and build confidence in vaccine efficacy and safety. Campaign activity includes paid advertising, media, stakeholder engagement and partnerships with a wide range of organisations.Whilst there is no room for complacency, UKHSA’s latest parental attitudes survey 2025, data shows that vaccine confidence remains high, with 84% of parents saying they trusted vaccines.We encourage people to speak to a trusted health professional about any vaccine concerns.

Whether he has made an assessment of the readiness of integrated care boards to assume responsibility for commissioning vaccination and immunisation services from April 2026.

The Government’s 10-Year Health Plan reaffirmed the importance of work to establish integrated care boards (ICBs) as ‘strategic commissioners of local health services, responsible for all but the most specialised commissioning’.In preparation for this, the NHS Executive commissioned a review of NHS England’s direct commissioning functions to make recommendations on the future arrangements for discharging these functions in light of the planned integration of NHS England into a restructured Department of Health and Social Care.The review, which has now been agreed, proposes transferring commissioning responsibility for suitable specialised services, vaccination and screening services, and health and justice services to ICBs. It is proposed that this transfer will take place, alongside the implementation of changes to legislation, in April 2027.Our expectation is that during 2026/27, ICBs will take a more central role in shaping these services. This will be achieved through closer collaboration and partnership with NHS England, as the accountable organisation, and will build on the strong joint working arrangements already in place this year for delegated specialised services. A development programme and safe transfer checklist will, alongside this closer working, help to ensure that ICBs are ready to take on their new responsibilities from April 2027.