Written questions by Raja.

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.

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 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.

When the National Institute for Health and Care Research will report on its evaluation into the Sickle Cell Disorder Emergency Department Bypass Unit pilots.

The NHS England pilot (Oct 2023 - July 2025) is being independently evaluated by the Rapid Service Evaluation Team (REVAL), which is funded by the National Institute for Health and Care Research (NIHR) and based at the University of Manchester. Preliminary findings are due in September 2025, with full results in December 2025.

Whether the Sickle Cell Disease Quality Improvement Programme will continue when the Department of Health and Social Care takes over the responsibilities of NHS England.

The Sickle Cell and Thalassaemia Quality Improvement Programme remains committed to improving outcomes and quality of life for people living with sickle cell and thalassaemia. The programme is taking targeted action to align to the commitments within the 10-Year Health Plan to reduce health inequalities nationally, to ensure people in these communities can live longer, healthier lives, spending less time in poor health.The integration of NHS England into the Department is not due to happen in this financial year, and all programmes of work will be reviewed in alignment with budget setting in future years.

What steps his Department is taking to help improve the Care Quality Commission’s registration process times; and what assessment he has made of the potential impact of those processing times on the (a) capacity and (b) continuity of care services.

The Care Quality Commission (CQC) does not record registration data in the format requested, for the timeliness of registration application processing by constituency.Dr Penny Dash published her report into the CQC in October 2024. The Government accepted her findings and has since been supporting the CQC to improve rapidly, as well as holding it to account for its performance.The Department meets regularly with the CQC to review performance. The volume of registration applications and reducing the backlog of registration applications over 10 weeks old is one of the four key priorities discussed at these meetings.The CQC has been making tangible progress. For all registration application received as care providers and registered managers in England, the percentage of applications older than 10 weeks has reduced significantly, from a peak of 61.1% in May 2024, to 32.9% in July 2025, a reduction of 28.2%.

What recent assessment he has made of the timeliness of Care Quality Commission processing of applications for registration as (a) care providers and (b) registered managers in (i) England and (ii) Leicester East constituency.

The Care Quality Commission (CQC) does not record registration data in the format requested, for the timeliness of registration application processing by constituency.Dr Penny Dash published her report into the CQC in October 2024. The Government accepted her findings and has since been supporting the CQC to improve rapidly, as well as holding it to account for its performance.The Department meets regularly with the CQC to review performance. The volume of registration applications and reducing the backlog of registration applications over 10 weeks old is one of the four key priorities discussed at these meetings.The CQC has been making tangible progress. For all registration application received as care providers and registered managers in England, the percentage of applications older than 10 weeks has reduced significantly, from a peak of 61.1% in May 2024, to 32.9% in July 2025, a reduction of 28.2%.

What steps he is taking to improve Care Quality Commission processing times for the registration of care providers in (a) England and (b) Leicester East constituency.

The Care Quality Commission (CQC) does not record registration data in the format requested, for the timeliness of registration application processing by constituency.Dr Penny Dash published her report into the CQC in October 2024. The Government accepted her findings and has since been supporting the CQC to improve rapidly, as well as holding it to account for its performance.The Department meets regularly with the CQC to review performance. The volume of registration applications and reducing the backlog of registration applications over 10 weeks old is one of the four key priorities discussed at these meetings.The CQC has been making tangible progress. For all registration application received as care providers and registered managers in England, the percentage of applications older than 10 weeks has reduced significantly, from a peak of 61.1% in May 2024, to 32.9% in July 2025, a reduction of 28.2%.

What assessment he has made of the potential implications for his policies of instances of pre-term infants both (a) not receiving the maternal vaccination programme for respiratory syncytial virus and (b) not being eligible for palivizumab.

The respiratory syncytial virus (RSV) vaccination programme to protect newborn infants, via maternal vaccination, was introduced in England in September 2024, in line with independent expert advice from the Joint Committee on Vaccination and Immunisation (JCVI). The National Health Service has also offered high-risk eligible infants a monoclonal antibody called palivizumab over the RSV season since 2010, and continues to do so. Palivizumab is typically reserved for premature infants with specific major underlying medical conditions.The JCVI is aware that very premature babies are unlikely to benefit from maternal vaccination. In February 2023, the JCVI advised that existing infant risk groups eligible for RSV monoclonal antibody immunisation should preferentially be protected with nirsevimab over palivizumab. In October 2024, the committee supported work being taken forward for a monoclonal antibody programme to protect all very/extremely premature infants, ideally from 2025/26. We are exploring all options to ensure there is effective protection against severe RSV illness for all very premature infants.

What steps his Department is taking to improve data transparency for vaccination uptake figures for the maternal respiratory syncytial virus vaccination programme by reducing the four-month lag in reporting.

Respiratory syncytial virus (RSV) maternal vaccine uptake methodology is published on the GOV.UK website, and includes an explanation of the data sources and their reporting lags, in the monthly RSV maternal vaccination coverage reports, which are available at the following link:https://www.gov.uk/government/publications/rsv-immunisation-for-older-adults-and-pregnant-women-vaccine-coverage-in-englandThe data collection methodology chosen ensures that robust and precise coverage estimates are calculated for the maternal programme.

What his planned timeline is for the publication of an assessment of the (a) efficacy and (b) impact of the maternal vaccination programme for respiratory syncytial virus.

The UK Health Security Agency undertakes monitoring and evaluation of immunisation programmes, including the effectiveness of vaccines. Monitoring and evaluation work has begun for the new respiratory syncytial virus programmes which launched in September 2024 to protect infants through maternal vaccination and for direct protection of older adults. Findings will be published in due course.

How much (a) NHS England and (b) NHS Trusts spent on postage in the 2024–25 financial year; and what steps he is taking to help reduce these costs.

Data on National Health Service total spend on postage for the 2024/25 financial year in England is not held centrally, and will be held locally by individual trusts.

What steps his Department is taking to support (a) hidden and (b) unpaid carers from ethnic minority communities; and whether he has made an assessment of support needs in Leicester East constituency.

Local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers. Local authorities are required to undertake Carer’s Assessments to support people caring for their family and friends who appear to have a need for support, and to meet their eligible needs upon request from them.The Department works with the sector and partners to deliver an annual programme of universal and targeted support to local authorities and their partners. This includes the Partners in Care and Health (PCH) contract.PCH’s work to support sector partners includes a workstream dedicated to supporting local authorities’ work with unpaid carers. This workstream includes work to identify and support unpaid carers, with a particular focus on identifying those from ethnic minority communities and those who are least likely to self-identify as a carer.

Whether his Department is taking steps to ensure that family carers are meaningfully involved in the (a) planning and (b) decision-making processes of local integrated care systems.

Under the National Health Service Act 2006, integrated care boards (ICBs) must make arrangements to ensure patients, and their carers and representatives are involved in the planning and commissioning of health and care, whether through consultation or the provision of information. While developing the Joint Forward Plans, ICBs and partner trusts must consult with individuals, patients, carers, and communities in the planning process to ensure the plan reflects the needs and preferences of the local population. The Health and Care Act 2022 introduced provisions for ICBs to promote the involvement of patients, and their carers and representatives, if any, in decisions relating to the care and treatment of the person they care for.

What steps his Department is taking to (a) identify and (b) support (i) hidden and (ii) unpaid family carers who (A) are and (B) are not engaged with formal care systems.

Local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers. Local authorities are required to undertake Carer’s Assessments to support people caring for their family and friends who appear to have a need for support, and to meet their eligible needs upon request from them.The Department works with the sector and partners to deliver an annual programme of universal and targeted support to local authorities and their partners. This includes the Partners in Care and Health (PCH) contract.PCH’s work to support sector partners includes a workstream dedicated to supporting local authorities’ work with unpaid carers. This workstream includes work to identify and support unpaid carers, with a particular focus on identifying those from ethnic minority communities and those who are least likely to self-identify as a carer.

What steps his Department is taking to improve NHS (a) engagement with and (b) leadership responsiveness to small community-led carer networks.

We recognise the importance of listening to and partnering with people who use the National Health Service, their unpaid carers and the organisations and networks that represent them. The Health and Care Act 2022 introduced new duties for NHS England and integrated care boards to involve carers in public engagement.I chair a regular cross-government meeting made up of ministers from the Department of Health and Social Care, Department for Work and Pensions, Department for Business and Trade, and Department for Education, as well as senior officials from NHS England, to consider how we can provide unpaid carers with the recognition and support they deserve.NHS England and the Department also regularly engages with both national charities, local carer organisations and unpaid carers directly.

Whether his Department plans to reverse the decision to raise the minimum age for eligibility for a COVID-19 booster as part of the spring vaccination programme.

The independent Joint Committee on Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation programmes. The aim of the COVID-19 vaccination programme is to prevent serious disease, leading to hospitalisation and/or mortality, arising from COVID-19.The JCVI has advised that the available national data continues to demonstrate that older people and those who are immunosuppressed are at greatest risk of hospitalisation and death from COVID-19. The data available to the JCVI is national data, and they therefore made no assessment specific to Leicester.On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme for spring 2025, autumn 2025, and spring 2026. This advice can be found at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026On 12 December 2024, the Government accepted the JCVI’s advice that a COVID-19 vaccine should be offered in spring 2025 to adults aged 75 years old and over, residents in a care home for older adults, and the immunosuppressed aged six months old and over. The Government’s response can be found at the following link:https://www.gov.uk/government/news/advice-accepted-on-spring-2025-covid-19-vaccination-programmeEligibility for the spring 2025 campaign, including minimum age requirements, is the same as in previous spring campaigns, such as the 2024 campaign. The Government has no plans to change eligibility for spring 2025, and has accepted the JCVI’s advice for this campaign in full. The spring 2025 campaign began in England on 1 April, and will conclude on 17 June.The JCVI also advised on eligibility for the autumn 2025 and spring 2026 programmes. The Government is considering this advice carefully and will respond in due course.

Whether his Department has made an assessment of the potential impact of raising the minimum age for eligibility for the COVID-19 booster during the spring vaccination programme on healthcare services in (a) Leicester and (b) England.

The independent Joint Committee on Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation programmes. The aim of the COVID-19 vaccination programme is to prevent serious disease, leading to hospitalisation and/or mortality, arising from COVID-19.The JCVI has advised that the available national data continues to demonstrate that older people and those who are immunosuppressed are at greatest risk of hospitalisation and death from COVID-19. The data available to the JCVI is national data, and they therefore made no assessment specific to Leicester.On 13 November 2024, the JCVI published advice on the COVID-19 vaccination programme for spring 2025, autumn 2025, and spring 2026. This advice can be found at the following link:https://www.gov.uk/government/publications/covid-19-vaccination-in-2025-and-spring-2026-jcvi-advice/jcvi-statement-on-covid-19-vaccination-in-2025-and-spring-2026On 12 December 2024, the Government accepted the JCVI’s advice that a COVID-19 vaccine should be offered in spring 2025 to adults aged 75 years old and over, residents in a care home for older adults, and the immunosuppressed aged six months old and over. The Government’s response can be found at the following link:https://www.gov.uk/government/news/advice-accepted-on-spring-2025-covid-19-vaccination-programmeEligibility for the spring 2025 campaign, including minimum age requirements, is the same as in previous spring campaigns, such as the 2024 campaign. The Government has no plans to change eligibility for spring 2025, and has accepted the JCVI’s advice for this campaign in full. The spring 2025 campaign began in England on 1 April, and will conclude on 17 June.The JCVI also advised on eligibility for the autumn 2025 and spring 2026 programmes. The Government is considering this advice carefully and will respond in due course.

What recent assessment his Department has make of the adequacy of the NHS Job Evaluation Scheme (a) matrices and (b) formulae used to determine Agenda for Change pay bandings; and whether he has plans to update the assessment framework.

The Job Evaluation Scheme (JES) underpins pay for National Health Service staff under the Agenda for Change Terms and Conditions. The JES model of weighting and scoring job documentation has been legally tested and proven to be robust, therefore we have no plans to review the system at this time.The NHS Staff Council’s Job Evaluation Group periodically reviews and updates the national role profiles that are used to support job evaluation practice to ensure their accuracy.