Written questions by Adam.

What assessment he has made of the potential merits of a national clinical lead for disease related malnutrition within his Department.

NHS England has produced nutrition and hydration guidance for commissioners, which is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdfThere are also national organisations which provide guidance, promote best practice, and raise awareness of malnutrition for those working in across the National Health Service and social care.For these reasons, no assessment has been made specifically of the potential merits of a national clinical lead for disease-related malnutrition.

Pursuant to the Answer of 25 November 2025 to Question 92292, what assessment his Department has made of the potential impact of the requirement for pre-visit notifications on the uptake of free eye health screening on people experiencing long term homelessness.

No such assessment has been made. Individuals experiencing homelessness can access NHS sight tests from high street optical practices. NHS England have made it clear to local commissioning teams that a patient without a fixed address should not be prevented from accessing high street NHS sight testing services.

What steps he is taking to ensure that Integrated Care Boards provide equal levels of funding for children's hospices.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member for Leicester South and the Rt. Hon. Member for Chingford and Woodford Green to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.We are 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. We are providing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

What assessment his department has made of the potential impact of the requirement for a pre-visit notification on access to eye care for a) people experiencing homelessness and b) care home residents.

National Health Service funded domiciliary, mobile, sight tests are available for patients who are eligible for free NHS sight tests, and who would have difficulties accessing care through the high-street due to physical or mental illness, or disability, or who would have difficulties communicating their health needs unaided. As well as services being provided in residential homes, these services can also be provided in day centres.In order to ensure people experiencing homelessness can access NHS sight tests on the high street, NHS England issued a clarification via local commissioning teams to ensure that having no fixed abode should not prevent access to NHS care. Integrated care boards can also commission enhanced eye care services, where they feel these are needed to meet local needs.

Whether he intends to remove the requirement for a pre-visit notification (PVN) for eye care assessments for people experiencing homelessness.

National Health Service funded domiciliary, mobile, sight tests are available for patients who are eligible for free NHS sight tests, and who would have difficulties accessing care through the high-street due to physical or mental illness, or disability, or who would have difficulties communicating their health needs unaided. As well as services being provided in residential homes, these services can also be provided in day centres.In order to ensure people experiencing homelessness can access NHS sight tests on the high street, NHS England issued a clarification via local commissioning teams to ensure that having no fixed abode should not prevent access to NHS care. Integrated care boards can also commission enhanced eye care services, where they feel these are needed to meet local needs.

What steps his Department is taking to support the use of medical technologies to prevent sight loss.

As outlined in the 10-Year Health Plan and the Life Sciences Sector Plan, we want patients to have fast and safe access to the most innovative technology, wherever they live in the country. Improving the adoption and procurement of medical technology will help the National Health Service secure the best outcomes for patients, including patients with sight threatening conditions, whilst also delivering greater value-for-money for the NHS.The Department invests over £1.6 billion each year on research, including on eye care, through its research delivery arm, the National Institute for Health and Care Research.The National Institute for Health and Care Excellence (NICE) is the independent body responsible for evaluating new medicines, medical devices, and other technologies to determine their clinical and cost-effectiveness before recommending them for NHS use.Where a NICE technology appraisal recommends a medicine or treatment, the NHS is legally required to fund them. Where NICE guidance is not available on a particular medical technology, we would expect commissioners to take funding decisions on the basis of the available evidence of the clinical benefits.

What steps his Department is taking to improve patient access to innovative medical technologies designed to prevent glaucoma.

As outlined in the 10-Year Health Plan and the Life Sciences Sector Plan, we want patients to have fast and safe access to the most innovative technology, wherever they live in the country. Improving the adoption and procurement of medical technology will help the National Health Service secure the best outcomes for patients, including patients with sight threatening conditions, whilst also delivering greater value-for-money for the NHS.The Department invests over £1.6 billion each year on research, including on eye care, through its research delivery arm, the National Institute for Health and Care Research.The National Institute for Health and Care Excellence (NICE) is the independent body responsible for evaluating new medicines, medical devices, and other technologies to determine their clinical and cost-effectiveness before recommending them for NHS use.Where a NICE technology appraisal recommends a medicine or treatment, the NHS is legally required to fund them. Where NICE guidance is not available on a particular medical technology, we would expect commissioners to take funding decisions on the basis of the available evidence of the clinical benefits.

What steps his Department is taking through the NHS 10 Year Health Plan to improve glaucoma care.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future, from hospital to community, from analogue to digital, and from sickness to prevention. All of these are relevant to preventing and managing conditions such as glaucoma. More tests and scans delivered in the community and better joint working between services will support the management of conditions, including glaucoma, closer to home.

What assessment his Department has made of the potential merits of (a) trabecular bypass procedures at the time of cataract surgery and (b) other minimally invasive glaucoma surgeries in delaying glaucoma progression.

No such assessment has been made.The best treatment options for any individual patient will be decided by the treating clinician in discussion with the patient, taking into account relevant National Institute for Health and Care Excellence (NICE) guidance.NICE guidance on trabecular stent bypass microsurgery for open-angle glaucoma sets out that trabecular bypass surgery can be combined with a cataract operation and has shown its ability to reduce intraocular pressure.

What assessment he has made of the potential impact of (a) trabecular bypass procedures and (b) other minimally invasive glaucoma surgeries on preventing glaucoma progression.

No such assessment has been made.The best treatment options for any individual patient will be decided by the treating clinician in discussion with the patient, taking into account relevant National Institute for Health and Care Excellence (NICE) guidance.NICE guidance on trabecular stent bypass microsurgery for open-angle glaucoma sets out that trabecular bypass surgery can be combined with a cataract operation and has shown its ability to reduce intraocular pressure.

What steps his Department is taking to prevent irreversible sight loss caused by glaucoma.

Regular sight tests play a crucial role in the early detection of glaucoma, which is often symptomless in the early stages. Free National Health Service sight tests are available for many, including individuals diagnosed with glaucoma or aged 40 years old and over with a close family history of glaucoma. NHS England testing has shown how improved IT connectivity between primary and secondary eye care services and the development of a single point of access could improve the referral and triage of eye care patients, reducing the time from referral to treatment and supporting more patients to be managed in the community.The Getting It Right First Time programme is also currently developing best practice guidance for glaucoma services to support the adoption of high standards across the pathway, from detection onwards.

With reference to the press notice entitled 100,000 more people get quicker care thanks to GP funding reform, published on 4 September 2025, whether he plans to allocate funding for advice and guidance services to (a) other areas of primary care and (b) optometry services.

The expansion of and funding for Advice and Guidance and referral triage more broadly for 2026/27 are currently under consideration, and a decision will be confirmed later this year.

What steps his Department is taking to help increase the use of the optometry workforce in (a) early intervention and (b) prevention of avoidable sight loss.

Integrated care boards (ICBs) are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests, whether provided by the NHS or privately, play a vital role in the early detection of sight threatening eye conditions.ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

Whether he has held discussions on the development of a National Eye Care Framework in England; and whether patients and sector experts will be consulted as part of that process.

The 10-Year Health Plan supports more locally developed and integrated neighbourhood care rather than a top-down, one-size-fits-all solution. Integrated care boards will want to take different approaches to commissioning primary and secondary eye care services, depending on the skills and resources available to them.

What steps his Department is taking to help reduce regional variations in access to eye care services; and what discussions his Department has had with the optometry sector on increasing the use of community-based care.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

What discussions his Department has had with stakeholders in the optometry sector on the future delivery of primary eye care services in the last 12 months.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

Whether his Department has made an assessment of the potential merits of expanding primary eye care services through high street optometry practices to support early detection of eye conditions.

Integrated care boards (ICBs) are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests, whether provided by the NHS or privately, play a vital role in the early detection of sight threatening eye conditions.ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

Whether the 10-Year Plan for Health will include primary care provision; and if he will work with (a) optometrists, (b) pharmacists and (c) dentists to deliver that plan.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

Whether the 10 Year Health Plan for England will include primary care provision; and if he will make it his policy to work with (a) optometrists, (b) pharmacists and (c) dentists in delivering that plan.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

Whether his Department has made an assessment of the potential merits of using existing high street optometry practices to deliver diagnostic services.

High street optometrists play a vital role in the early detection of a range of eye conditions. Integrated care boards are responsible for commissioning primary and secondary eye care services and can commission additional diagnostic services from high street optometrists based on providers and priorities in their areas, for example additional testing to support effective referrals to secondary care.