Written questions by Aquarone.

Pursuant to the Answer of 29 November 2024 to Question 16285 on Methylphenidate: Shortages, what estimate he has made of the number of prescriptions for methylphenidate (a) successfully and (b) unsuccessfully fulfilled in Norfolk in 2024.

The Prescription Cost Analysis, produced by the NHS Business Services Authority (NHSBSA), provides the total number of prescription items of each medicine dispensed in the community in England.There were 28,249 National Health Service prescription items for the chemical substance methylphenidate dispensed by contractors in the Norfolk and Waveney Integrated Care Board, regardless of where prescribed, from January 2024 to October 2024. The NHSBSA does not hold data on unsuccessfully fulfilled prescriptions.

Pursuant to the Answer of 24 October 2024 to Question 9576 on Methylphenidate: Shortages, what recent progress her Department has made on improving the supply of methylphenidate in (a) Norfolk and (b) the UK.

We are continuing to work to resolve supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support the continued growth in demand for the short and long-term. We currently expect supply to improve in the United Kingdom throughout the rest of 2024. However, we anticipate supply to be limited for some strengths, and we continue to work with all suppliers to ensure the remaining issues are resolved as soon as possible.The Department has also worked with specialists to develop advice for National Health Service clinicians on prescribing available alternative brands of methylphenidate prolonged-release tablets, whilst supplies are limited. If this is not possible, advice has also been provided for attention deficit hyperactivity disorder (ADHD) specialists to offer other clinically appropriate and available options, both pharmacological and non-pharmacological, in line with the National Institute of Health and Care Excellence guidance, in order to avoid potentially disruptive breaks in treatment. To improve supply chain resiliency, we are also working with prospective new suppliers of methylphenidate prolonged-release tablets to expand the UK supplier base. We are supporting an ADHD taskforce that NHS England is establishing to examine ADHD service provision. The taskforce will bring together expertise from across a broad range of sectors, including the NHS, education, and justice, to help provide a joined-up approach in response to concerns around rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines. The Department continually updates a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website. This helps ensure those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients. This list is available at the following link: www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd

If he will support the implementation of the Optimal Care Pathway for pancreatic cancer.

We are committed to transforming the National Health Service so that we diagnose cancer earlier, treat it faster, and improve survival rates.On 12 September 2024 the National Cancer Audit Collaborating Centre published their State of the Nation Report on Pancreatic Cancer, and the NHS cancer programme is currently considering how to take forward the initial recommendations of that audit. NHS England is also funding a new audit into pancreatic cancer to increase the consistency of access to treatments, and to stimulate improvements in cancer treatment and outcomes for patients.For people with higher risk due to family history, NHS England is providing options for enhanced pancreatic cancer surveillance. They are also creating pathways to support faster referral routes for people with non-specific symptoms and increasing direct access for general practitioners to diagnostic tests.

Whether (a) pancreatic cancer and (b) other cancers with lower survival rates will have a focused section in the new cancer strategy.

The Government’s Health Mission sets the aim of building a National Health Service fit for the future and reducing the lives lost to the biggest killers, including cancer. As part of that work, and in response to Lord Darzi’s report, we have launched an extensive programme of engagement to develop a 10-Year Health Plan to reform the NHS, including further detail pancreatic cancer and other cancers with lower survival rates. The plan will set out a bold agenda to deliver on the three big shifts from hospitals to the community, from analogue to digital, and from sickness to prevention. In addition, following publication of the 10-Year Health Plan, we will develop a new national cancer plan, which will include further details on how we will improve outcomes for cancer patients including those with pancreatic cancer and other cancers with lower survival rates. 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, and will provide updates on this in due course.

If he will make an assessment of the potential merits of establishing a fund to support GP services in (a) rural and (b) other remote areas.

General practitioners receive global sum funding for providing core services, comprising approximately 50 to 60% of practice income. The global sum is a capitated payment, calculated based on the size of a practice’s registered list of patients, and weighted using the Carr-Hill formula. Through the Carr-Hill formula, payments to practices are adjusted in consideration of several factors, including the geographical location of a practice. This includes accounting for the additional costs of delivering services in rural areas, and in areas where staff costs are higher.

Whether his Department plans to review recent closures of GP surgeries.

The closure of a general practice (GP) surgery is an issue that is considered and decided upon by local commissioners, following an application from a GP provider. Practices close for a variety of reasons, including mergers or retirement, and so do not necessarily indicate a reduction in the quality of care. When a practice does close, patients are informed of the closure and advised to register at another local practice of their choice, within their area.Commissioners are accountable for ensuring that patients have access to a GP. In the event of a closure, commissioners will assess the need for a replacement provider before transferring patients to alternative practices when a GP surgery closes.