Written questions by Opher.

With reference to page 12 of the document entitled Reforming elective care for patients, published on 6 January 2025, what steps he plans to take to implement shared decision-making.

The Elective Reform Plan, published on 6 January 2025, sets out the reform and productivity efforts needed to ensure that patients are seen on time and have the best possible experience during their care. Shared decision making is an important part of good patient experience, ensuring that patients have greater empowerment, autonomy, and control over their care. Shared decision making is not a new concept but is a key component of universal personalised care that we are committed to delivering and expanding. Improving digital tools will be essential, and changes to the NHS App will help to improve communication and shared decision making between patients and clinicians. We have committed to ensuring that at least 85% of acute trusts will be able to provide information about their elective appointments to patients on the NHS App by the end of March 2025. We will also make more types of content about patients’ treatment available on the NHS App, such as discharge letters, by December 2025. We will also support all trusts to adopt digital patient engagement portals (PEPs) which enable patients and their healthcare team to send messages and share documents. We understand, though, that digital options do not work for everyone and we will continue to provide high quality, non-digital options for those who want and need them. Providing customer-care training to patient facing non-clinical staff will form another key part of supporting patients to make informed decisions about their care. The plan outlines that we will be expanding opportunities for self-management and remote monitoring which will empower patients to manage long-term conditions in ways which are more convenient for their lives. The National Health Service will use digital questionnaires through PEPs and the NHS App to make remote monitoring a standard offer to patients with long-term conditions, following agreement with their healthcare team. Shared decision making between patients and clinicians is a cornerstone of supporting more patient initiated follow-ups (PIFU), helping patients to be seen quickly when required, whilst avoiding the inconvenience of appointments they do not need. We have set out the aim of increasing PIFU uptake to at least 5% of all outpatient appointments by March 2029.

What assessment he has made of the potential (a) barriers and (b) costs for NHS trusts in implementing the perioperative care measures outlined in the document entitled Reforming elective care for patients, published on 6 January 2025.

The perioperative care measures outlined in the Elective Care Reform plan build on existing NHS England led work to improve perioperative care including guidance on Earlier screening, risk assessment and health optimisation for adult patients due to have inpatient care. The guidance is available at the following link:https://www.england.nhs.uk/publication/earlier-screening-risk-assessment-and-health-optimisation-in-perioperative-pathways-guide-for-providers-and-integrated-care-boardsNHS England has worked closely with systems and providers including through onsite visits and system level engagement to understand the key barriers to implementing the perioperative care measures outlined in the Elective Reform Plan.Whilst costings will vary between organisations, measures from this work alongside supporting improved patient experience and outcomes, will support the delivery of sustainable clinical pathways. This will lead to reduced waste in the National Health Service, for example by ensuring productivity in theatres is maximised.

With reference to document entitled the Reforming elective care for patients, published on 6 January 2025, what estimate he has made of the size of the workforce needed to implement the (a) perioperative care measures and (b) requirements for anaesthetists outlined in that plan.

The Elective Reform Plan sets out the reform and productivity efforts needed to ensure that patients are seen on time and have the best possible experience during their care. Improving perioperative care can increase productivity by reducing cancellations, reducing length of stay, and minimising postoperative complications.The Government will work closely with NHS England to develop a new long-term workforce plan for the National Health Service.

With reference to the document entitled Reforming elective care for patients, published on 6 January 2025, which groups of patients will be offered the prehabilitation services outlined in that plan; and if he will make an assessment of the potential merits of extending those services to all patients referred for surgery.

The Elective Care Reform Plan identifies the importance of supporting all patients to take control of their health, for example through smoking cessation and weight loss programmes, as they prepare for their surgery. As well as improving patient outcomes, this can also enable patients to be treated in lower acuity settings, for example in day case settings enabling patients to go home the same day.The plan states that NHS England will work through Cancer Alliances to support improvements in prehabilitation for people about to undergo cancer treatment. The approach to this will be informed by the Macmillan Cancer Support/National Institute of Health and Care Research guidance for healthcare professionals, which is available at the following link:https://www.macmillan.org.uk/healthcare-professionals/news-and-resources/guides/principles-and-guidance-for-prehabilitationAn update on this guidance is expected in spring 2025, alongside existing good practice examples.Current NHS England guidance requires acute trusts in England to adopt earlier screening, risk assessment and health optimisation for adult patients waiting for inpatient surgery, with more information available at the following link:https://www.england.nhs.uk/publication/earlier-screening-risk-assessment-and-health-optimisation-in-perioperative-pathways-guide-for-providers-and-integrated-care-boardsNHS England will continue to identify and work with areas of England that have programmes in place for different groups of patients waiting for surgery, including prehabilitation programmes to support patients having major surgery and waiting well programmes to support patients having all types of surgery, to learn from and share best practice.

Whether hubs that provide open access mental health services for children and young people in every community will be delivered only through the Young Futures programme.

The Government is committed to improving mental health support for children and young people, as demonstrated by our pledge to roll out a network of Young Futures Hubs in every community to provide open access mental health support. We are currently working across Government to deliver Young Futures Hubs, to bring together services, including mental health support, to improve how young people access opportunities and support at community level.We will also improve mental health support for children and young people by providing access to a specialist mental health professional in every school and recruiting 8,500 additional mental health workers to help cut waiting lists across the country.

What steps his Department plans to take to deliver 700,000 additional urgent dental appointments each year.

The Government is committed to tackling the challenges for patients trying to access National Health Service dental care. We are working to ensure that patients can start to access 700,000 additional urgent dental appointments as soon as possible, targeting areas that need them most. We will set out further information on this commitment, including how this will be measured, in due course.

When he plans to begin rolling out measures to deliver the 700,000 additional urgent dental appointments this financial year; and how many such appointments he plans to deliver within the same period.

The Government is committed to tackling the challenges for patients trying to access National Health Service dental care. We are working to ensure that patients can start to access 700,000 additional urgent dental appointments as soon as possible, targeting areas that need them most. We will set out further information on this commitment, including how this will be measured, in due course.

Whether he plans to commission further waves of the Mental Health of Children and Young People in England report.

The Department recognises the importance of the Mental Health of Children and Young People in England Report. We will publish plans in due course.

How many blood cancer patients have been diagnosed via Non-Specific Symptom pathways in each of the last three years.

The capturing of non-specific symptom pathway outcomes was introduced in July 2023. From July 2023 to October 2024, 263 patients have been diagnosed via non-specific symptom pathways. Further information is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/supplementary-information/The National Disease Registration Service (NDRS), through the National Cancer Registration and Analysis Services, collects information on how many people in England have cancer.Blood cancer is included as a distinct category in the NDRS, labelled haematological neoplasms. The NDRS’ website also shows the number of people treated for different tumour types by treatment type, as well as survival rates, mortality rates, and data on urgent suspected cancer referrals. Further information is available at the following link:https://www.cancerdata.nhs.uk/

If he will meet the Blood Cancer Alliance to discuss the need to include specific measures to improve blood cancer (a) diagnosis, (b) treatment and (c) care in the forthcoming cancer strategy.

There are no current plans to introduce a specific proxy staging measure or a corresponding national target to support the earlier diagnosis of blood cancers. To tackle late diagnoses of blood cancers, the National Health Service is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.The National Disease Registration Service, through the National Cancer Registration and Analysis Services, collects information on how many people in England have blood cancer, labelled as haematological neoplasms. The National Disease Registration Service’s website shows the number of people treated for different tumour types by treatment type, as well as survival rates, mortality rates, and data on urgent suspected cancer referrals. This data supports service provision and commissioning in the NHS, clinical audits, and public health and epidemiological research, all of which contributes to improved outcomes, including for blood cancer patients. Further information is available at the following link:https://www.cancerdata.nhs.uk/As part of the Government’s five long-term missions, we have launched a 10-Year Health Plan to reform the NHS and make it fit for the future. 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 sickness to prevention, and will be co-designed with the public, staff, and patients. I would encourage you to engage via our online portal, which is available at the following link: https://change.nhs.uk/en-GB/My Rt Hon. Friend, the Secretary of State for Health and Social Care has been clear that there should be a National Cancer Plan. We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be. We will provide updates on this in due course, including on how we plan to engage blood cancer partners.I met with the Hon. Member for Poole and Blood Cancer UK, a member of the Blood Cancer Alliance, on 22 October 2024 to discuss the UK Blood Cancer Action Plan.

If his Department will (a) introduce emergency presentation as a proxy staging measure for non-stageable blood cancers and (b) apply a corresponding national target to (i) measure and (ii) support reduction of late diagnosis of blood cancer.

There are no current plans to introduce a specific proxy staging measure or a corresponding national target to support the earlier diagnosis of blood cancers. To tackle late diagnoses of blood cancers, the National Health Service is implementing non-specific symptom pathways for patients who present with symptoms such as weight loss and fatigue, which do not clearly align to a tumour type. Blood cancers are one of the most common cancer types diagnosed through these pathways.The National Disease Registration Service, through the National Cancer Registration and Analysis Services, collects information on how many people in England have blood cancer, labelled as haematological neoplasms. The National Disease Registration Service’s website shows the number of people treated for different tumour types by treatment type, as well as survival rates, mortality rates, and data on urgent suspected cancer referrals. This data supports service provision and commissioning in the NHS, clinical audits, and public health and epidemiological research, all of which contributes to improved outcomes, including for blood cancer patients. Further information is available at the following link:https://www.cancerdata.nhs.uk/As part of the Government’s five long-term missions, we have launched a 10-Year Health Plan to reform the NHS and make it fit for the future. 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 sickness to prevention, and will be co-designed with the public, staff, and patients. I would encourage you to engage via our online portal, which is available at the following link: https://change.nhs.uk/en-GB/My Rt Hon. Friend, the Secretary of State for Health and Social Care has been clear that there should be a National Cancer Plan. We are now in discussions about what form that plan should take, and what its relationship to the 10-Year Health Plan and the Government’s wider Health Mission should be. We will provide updates on this in due course, including on how we plan to engage blood cancer partners.I met with the Hon. Member for Poole and Blood Cancer UK, a member of the Blood Cancer Alliance, on 22 October 2024 to discuss the UK Blood Cancer Action Plan.

If he will publish (a) the number of blood cancer patients diagnosed via Non-Specific Symptom pathways and (b) other data on the performance of such pathways.

The capturing of non-specific symptom pathway outcomes was introduced in July 2023. From July 2023 to October 2024, 263 patients have been diagnosed via non-specific symptom pathways. Further information is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/supplementary-information/The National Disease Registration Service (NDRS), through the National Cancer Registration and Analysis Services, collects information on how many people in England have cancer.Blood cancer is included as a distinct category in the NDRS, labelled haematological neoplasms. The NDRS’ website also shows the number of people treated for different tumour types by treatment type, as well as survival rates, mortality rates, and data on urgent suspected cancer referrals. Further information is available at the following link:https://www.cancerdata.nhs.uk/

What assessment he has made of the potential health benefits of improving access to cycles for people on low incomes.

We know that reducing physical inactivity is beneficial for everyone and evidence suggests that cycling has positive physical and mental health benefits. Public Health England’s cycling and walking evidence review, published in 2018, found mixed evidence for whether increasing cycling in deprived socioeconomic status groups is more beneficial than in the general population. This review is available at the following link:https://assets.publishing.service.gov.uk/media/5bf41840e5274a2af47c464e/Cycling_and_walking_for_individual_and_population_health_benefits.pdfThe Department of Health and Social Care is currently working with the Department for Transport, and Active Travel England, on an updated evidence review, which will further examine active travel’s impact on mental health, physical health, and health inequalities. Findings are expected by mid-2025.

What plans he has to reduce the waiting list for ADHD diagnosis.

The Department is currently considering next steps to improve access to attention deficit hyperactivity disorder (ADHD) assessments. It is the responsibility of integrated care boards to make appropriate provision to meet the health and care needs of their local population, including ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.We are supporting a taskforce that NHS England is establishing to look at ADHD service provision and its impact on patient experience. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD and to help provide a joined-up approach in response to concerns around rising demand.Alongside the work of the taskforce, NHS England will continue to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems which are trialling innovative ways of delivering ADHD services to ensure best practice is captured and shared across the system.

What steps his Department is taking to help vaccinate children against chicken pox.

The Joint Committee on Vaccination and Immunisation (JCVI) recommended a universal varicella chickenpox vaccination programme be introduced as part of the routine childhood schedule. The JCVI statement is available at the following link:https://www.gov.uk/government/publications/childhood-varicella-vaccination-programme-jcvi-advice-14-november-2023/jcvi-statement-on-a-childhood-varicella-chickenpox-vaccination-programmeMinisters have accepted the JCVI recommendation, and the Department is in discussions with NHS England and the UK Health Security Agency on the potential implementation of the recommendation.

If he will suspend permission for non-surgical filler injections for gluteal fat grafting procedures.

The Government is currently considering what steps may need to be taken in relation to the safety of non-surgical cosmetic procedures, including filler injections. The Government will set out its position at the earliest opportunity.