Written questions by Barclay.

With reference to his NHS Pay Review Body remit letter: 2026 to 2027, what the expected annual financial impact is of changes to the implementation of the NHS Job Evaluation Scheme.

This specific assessment has not been made. No recent changes have been made to the Job Evaluation Scheme (JES) itself. Some job profiles have been updated to be assessed against locally.Following a national review by the Job Evaluation Group, the updated nursing and midwifery national profiles were republished by the NHS Staff Council on 3 June 2025. These changes did not change implementation of the JES or banding outcomes. During the evidence collection process for the nursing and midwifery national profile review, we were made aware that job documentation was often outdated, leading to concerns about pay banding outcomes through inconsistent local application of the JES.Any financial impact will largely depend on current local job evaluation practices and subsequent application of the revised profiles. The NHS England letter titled Agenda for Change non-pay deal recommendations – NHS job evaluation, dated 3 June 2025, was clear with employers that where there is out of date practice, they are accountable for correctly implementing the scheme and must ensure that all changes are implemented effectively within existing budget constraints.

What current unbudgeted pressures his Department is aware of within its spending plans.

The 2025 Spending Review was published on 11 June by HM Treasury and sets out departmental budgets for day‑to‑day spending until 2028/29, and until 2029/30 for capital investment. The 2025 Spending Review is available at the following link: https://www.gov.uk/government/publications/spending-review-2025-document The Department is now underway with a financial planning exercise to allocate budgets within those financial years. Spending plans will be set out in the Main Supply Estimates when published in due course by HM Treasury.

How many patients have been removed from the waiting lists for treatment for any other reason than the treatment had been completed, by month since July 2024.

The information requested is shown in the following table:Number of cases per month, from July 2024 to September 2025, where patients were removed from the Referral to Treatment (RTT) waiting list for reasons other than treatment:YearMonthNumber of cases2024July667,8932024August599,1912024September652,9242024October716,5242024November667,6452024December574,4492025January688,3252025February637,3152025March666,9082025April627,6922025May635,7132025June683,8632025July704,6252025August593,4552025September693,033The information for the table above was extracted from the Waiting List Minimum Data Set (WLMDS) on 18 November 2025.A breakdown of reasons for coming off the waiting list is not available in the aggregate monthly official statistics. However, the information is collected in the weekly management information from the Waiting List Minimum Data Set (WLMDS). The WLMDS is subject to less validation than the monthly official statistics and totals do not match between the two sources.Reasons for patients being removed from the waiting list can include them starting a period of active monitoring, a clinical decision not to treat, a patient declining treatment or a patient dying before treatment starts.

How many (a) headcount and (b) FTE staff were employed by NHS England on (a) 4 July 2024 and (b) 14 October 2025.

As of June 2024, the headcount for NHS England was 15,803, and the full-time equivalent staff employed was 14,327.6. These figures are published and available at the following link:https://www.gov.uk/government/collections/dhsc-workforce-management-information.We are still finalising figures for October, and this will be published in due course.

Whether he has made an estimate of the cost to the public purse of increasing the National Institute for Health and Care Excellence cost-effectiveness threshold by 25%.

The pharmaceutical sector and the innovative medicines it produces are critical to our national interest, helping people access life changing treatments, reducing pressure on the health service over the longer-term, and ensuring we have a National Health Service that is fit for the future.That is why through our Life Sciences Sector Plan, we have committed to working with industry to accelerate growth in spending on innovative medicines, compared to the previous decade. Our 10-Year Health Plan sets out how we will reform the National Institute for Health and Care Excellence.

How many patients have waited longer than 24 hours for treatment in A&E in the last 12 months.

NHS England publishes monthly data on accident and emergency (A&E) performance. This includes information on those A&E attendances that are 12 hours or longer for type 1 and 2 A&E providers. The data is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/

Pursuant to the Answer of 16 December 2024 to Question 16483 on Department of Health and Social Care: Staff, what the (a) headcount and (b) FTE number of officials working in his Department was in each month since October 2024.

This data is published monthly at the following link:https://www.gov.uk/government/collections/dhsc-workforce-management-information#2025

On what annual percentage increases in healthcare demand is the 10 Year Heath Plan based.

The 10-Year Health Plan is not based on a specific percentage growth rate in demand for health care. Instead, backed by an additional £29 billion, the plan sets out how the health system will seize the opportunities provided by new technology, medicines, and innovation to deliver better care for all patients, no matter where they live or how much they earn, as well as better value for taxpayers.

What the expected in-year cost of redundancy payments in (a) DHSC and (b) NHS England is in (i) 2025-26, (ii) 2026-27 and (iii) 2027-28.

Detailed plans are being formulated by a joint Department and NHS England programme team. The remit of work includes formulation of the relevant costs. Further detail on the costs and funding mechanisms will be provided as this work develops.

Whether he plans to issue further guidance to the NHS organisations on ending the recruitment of dedicated equality, diversity and inclusion staff.

National Health Service organisations should be working to address inequalities, in order to ensure the best possible outcomes for all patients, as well as tackling the abuse and discrimination that some NHS staff face in the workplace. Local NHS leaders are best placed to take an evidence-based approach to how they approach this challenge and resource this work.

How many (a) filled and (b) unfilled full-time equivalent roles there were in each of the NHS regional teams in (i) 2023-24, (ii) 2024-25 and (iii) 2025-26.

The following table sets out the full-time equivalent (FTE) staff in NHS England’s regional teams as of 30 March 2025:Directorates / RegionsBudgeted FTEStaff List FTEVacant FTEVacancy RateRegion - East of England804.1650.2153.919.10%Region - London1,032.50916.7115.811.20%Region - Midlands1,085.70929.7156.114.40%Region - North East & Yorkshire844.7759.385.410.10%Region - North West756.6684.771.99.50%Region - South East949.2783.6165.517.40%Region - South West710.3621.588.812.50%Total6,183.005,345.70837.313.50%Source: NHS EnglandNotes:Workforce data is collected at a single point as a ‘snapshot’, so we are unable to provide it for a whole financial year.We are unable to provide data at the equivalent time point within 2023/24 as data has not been validated, and the equivalent time point within 2025/26 has not happened yet.

Pursuant to the Answer of 14 May 2025 to Question 48901 on Motor Neurone Disease: Research, by what date he expects the total allocated to motor neurone disease research since the start of 2022-23 to exceed £50 million.

Government responsibility for delivering motor neurone disease research is shared between the Department of Health and Social Care, with research delivered via the National Institute for Health and Care Research (NIHR), and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation (UKRI), and in particular the Medical Research Council.The commitment to allocate £50 million to motor neurone disease research was introduced by the previous administration. Since the last parliamentary question on the commitment on 14 May, an additional contract is now public information, which confirms that a total of £50.2 million has been committed to motor neurone disease research since the start of the 2022/23 financial year. We will continue to invest in motor neurone disease research via open competition, with no maximum funding limit.The NIHR and UKRI will continue to welcome funding applications for research into any aspect of human health and care, including motor neurone disease. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality. Welcoming applications on motor neurone disease to all NIHR and UKRI programmes enables maximum flexibility both in terms of the amount of research funding a particular area can be awarded, and the type of research which can be funded.

What assessment he has made of the potential impact of the decision to discontinue the electronic Bed and Capacity Management Systems initiative on (a) A&E waits and (b) patient transfers.

The decision not to proceed with stand-alone investment into electronic bed management systems was based on value for money with other investments offering greater benefits for patients.The Government is committed to returning accident and emergency services to the standards patients rightly expect. Our new urgent and emergency care plan, published on 6 June 2025, sets out a fundamental shift in the approach to urgent and emergency care. It will drive collaboration across the system to deliver improvements for patients this year, backed by nearly £450 million of capital investment.

What steps he is taking to tackle inequalities in (a) waiting times and (b) access to treatment for cardiovascular disease patients in East England.

Patients have been let down for too long whilst they wait for the care they need, including patients awaiting cardiology care. The Government has committed to returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from Referral to Treatment (RTT), a standard which has not been met for almost a decade. As a first step, we have set a national target that 65% of patients wait 18 weeks or less by March 2026.The Elective Reform Plan commits to reforming elective care equitably and inclusively for all adults, children, and young people. The plan sets out the expectations for ICBs and providers to set a clear local vision for how health inequalities will be reduced as part of elective care reform, and to ensure interventions are in place to reduce disparities for groups who face additional waiting list challenges. To support this work, we have committed to improving the submission and quality of demographics data to increase understanding and insight into health inequalities.Cardiology is one of five priority specialties identified for significant elective reform in the Elective Reform Plan. Reforms include increasing specialist cardiology input earlier in patient care pathways, and improving access to cardiac diagnostic tests. These improvements to common cardiology pathways help standardise patient care, reduce inequalities, and improve access to care, especially in the early stages of pathways, for patients across England.In the East of England, performance against the 18-week RTT standard for cardiology is 58.1%, compared to 60.9% for cardiology nationally. Regionally, NHS England’s East of England Cardiac Network team is taking focussed action to reduce RTT waiting times, improve access to cardiac diagnostics such as echo and computed tomography coronary angiography, and ensure patients can readily access specialist services as required, such as the Inherited Cardiac Conditions services across the Royal Papworth Hospital and Norfolk, and the Norwich University Hospital.

What steps he is taking to improve access to (a) diagnostic equipment and (b) other services for inherited cardiac conditions in East England.

Inherited cardiac conditions (ICCs) are a group of largely monogenic disorders affecting the heart, its conducting system and vasculature. Waiting times data for ICCs is not available nationally in the Waiting List Minimum Data Set (WLDMS). Diagnosis codes, which could be used to identify patients with ICCs, are not collected in the WLMDS. While treatment codes are collected, there are no individual treatment codes for ICCs that could alternatively be used to identify patients waiting for treatment for an ICC. We are therefore unable to separate patients with an ICC from wider cardiac patients in England at a national or regional level. The NHS England East of England Cardiac Network team for 2025/26 focuses on improving referral to treatment times across cardiology, improving access to cardiac diagnostics and ensuring patients access the specialists service that is required such as the ICC services across Royal Papworth Hospital and Norfolk and Norwich University Hospital. We are taking steps to improve access to diagnostic equipment and other services for ICC in East England, including new innovations wherever possible. For example, James Paget University Hospital has piloted a scheme that focuses echocardiograms in heart failure referral pathways. This streamlines echocardiogram waits across all conditions. The scheme is now being planned in Queen Elizabeth Hospital King’s Lynn and being considered in Milton Keynes University Hospital as well as in Suffolk and North East Essex Integrated Care Board. NHS England is also piloting the ‘Beat to Treat’ programme at Queen Elizabeth Hospital King’s Lynn, which uses handheld, AI assisted echocardiograms in clinic and point of care testing for blood tests that are used to assess for heart failure. This will enable results to be received on the day and will allow for treatment to start at the first clinic appointment. This scheme will improve the accuracy of referrals for echocardiogram, refining the waiting list for this scan across all conditions, including ICC. There are plans to introduce a single point of access for all referrals to the ICC service in Cambridgeshire, namely Cambridge University Hospitals NHS Foundation Trust and Royal Papworth Hospital. Referrals will be triaged by both teams, to either the Royal Papworth Hospital or Cambridge University Hospitals NHS Foundation Trust element of the service and that there would be a clear standard operating procedure for how this would work and be managed, moving therefore to both sites operating as a joint service for these conditions. A multi-disciplinary team is already in place to support this, as well as access to newer therapies.

How many people in East England are currently awaiting treatment for inherited cardiac conditions; and if he will make a comparative estimate of the length of waiting times with the rest of the UK.

Inherited cardiac conditions (ICCs) are a group of largely monogenic disorders affecting the heart, its conducting system and vasculature. Waiting times data for ICCs is not available nationally in the Waiting List Minimum Data Set (WLDMS). Diagnosis codes, which could be used to identify patients with ICCs, are not collected in the WLMDS. While treatment codes are collected, there are no individual treatment codes for ICCs that could alternatively be used to identify patients waiting for treatment for an ICC. We are therefore unable to separate patients with an ICC from wider cardiac patients in England at a national or regional level. The NHS England East of England Cardiac Network team for 2025/26 focuses on improving referral to treatment times across cardiology, improving access to cardiac diagnostics and ensuring patients access the specialists service that is required such as the ICC services across Royal Papworth Hospital and Norfolk and Norwich University Hospital. We are taking steps to improve access to diagnostic equipment and other services for ICC in East England, including new innovations wherever possible. For example, James Paget University Hospital has piloted a scheme that focuses echocardiograms in heart failure referral pathways. This streamlines echocardiogram waits across all conditions. The scheme is now being planned in Queen Elizabeth Hospital King’s Lynn and being considered in Milton Keynes University Hospital as well as in Suffolk and North East Essex Integrated Care Board. NHS England is also piloting the ‘Beat to Treat’ programme at Queen Elizabeth Hospital King’s Lynn, which uses handheld, AI assisted echocardiograms in clinic and point of care testing for blood tests that are used to assess for heart failure. This will enable results to be received on the day and will allow for treatment to start at the first clinic appointment. This scheme will improve the accuracy of referrals for echocardiogram, refining the waiting list for this scan across all conditions, including ICC. There are plans to introduce a single point of access for all referrals to the ICC service in Cambridgeshire, namely Cambridge University Hospitals NHS Foundation Trust and Royal Papworth Hospital. Referrals will be triaged by both teams, to either the Royal Papworth Hospital or Cambridge University Hospitals NHS Foundation Trust element of the service and that there would be a clear standard operating procedure for how this would work and be managed, moving therefore to both sites operating as a joint service for these conditions. A multi-disciplinary team is already in place to support this, as well as access to newer therapies.

What steps he is taking to improve access to new innovations for people living with inherited cardiac conditions in East England.

Inherited cardiac conditions (ICCs) are a group of largely monogenic disorders affecting the heart, its conducting system and vasculature. Waiting times data for ICCs is not available nationally in the Waiting List Minimum Data Set (WLDMS). Diagnosis codes, which could be used to identify patients with ICCs, are not collected in the WLMDS. While treatment codes are collected, there are no individual treatment codes for ICCs that could alternatively be used to identify patients waiting for treatment for an ICC. We are therefore unable to separate patients with an ICC from wider cardiac patients in England at a national or regional level. The NHS England East of England Cardiac Network team for 2025/26 focuses on improving referral to treatment times across cardiology, improving access to cardiac diagnostics and ensuring patients access the specialists service that is required such as the ICC services across Royal Papworth Hospital and Norfolk and Norwich University Hospital. We are taking steps to improve access to diagnostic equipment and other services for ICC in East England, including new innovations wherever possible. For example, James Paget University Hospital has piloted a scheme that focuses echocardiograms in heart failure referral pathways. This streamlines echocardiogram waits across all conditions. The scheme is now being planned in Queen Elizabeth Hospital King’s Lynn and being considered in Milton Keynes University Hospital as well as in Suffolk and North East Essex Integrated Care Board. NHS England is also piloting the ‘Beat to Treat’ programme at Queen Elizabeth Hospital King’s Lynn, which uses handheld, AI assisted echocardiograms in clinic and point of care testing for blood tests that are used to assess for heart failure. This will enable results to be received on the day and will allow for treatment to start at the first clinic appointment. This scheme will improve the accuracy of referrals for echocardiogram, refining the waiting list for this scan across all conditions, including ICC. There are plans to introduce a single point of access for all referrals to the ICC service in Cambridgeshire, namely Cambridge University Hospitals NHS Foundation Trust and Royal Papworth Hospital. Referrals will be triaged by both teams, to either the Royal Papworth Hospital or Cambridge University Hospitals NHS Foundation Trust element of the service and that there would be a clear standard operating procedure for how this would work and be managed, moving therefore to both sites operating as a joint service for these conditions. A multi-disciplinary team is already in place to support this, as well as access to newer therapies.

What steps he is taking to ensure there is adequate infrastructure to offer access to treatment for people living with inherited cardiac conditions in the East of England.

NHS England has a published a national service specification for inherited cardiac conditions. This sets out what guidance should be followed, and the services provided to support diagnosis and treatment of patients with previously undiagnosed cardiac disease. This also includes support to families requiring follow up due to a death from this cause. The specification is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2017/11/cardiology-inherited-cardiac-conditions.pdfThe national service specification also includes a requirement for specialised inherited cardiac conditions services to investigate suspected cases.NHS England is currently reviewing this service specification working with a broad range of stakeholders including NHS clinical experts, the Association of Inherited Cardiac Conditions, Cardiomyopathy UK, Heart Valve Voice and the British Heart Foundation.There are plans for all referrals to the Inherited Cardiac Conditions service in Cambridgeshire to go to Cambridge University Hospitals NHS Foundation Trust and Royal Papworth Hospital. This will operate a specialist centre for Cambridgeshire, with a multi-disciplinary team already in place to support this.

What steps his Department plans to take to help improve the career progression of (a) nurses from Agenda for Change Band Five to Band Six and (b) other nurses in the context of plans not to introduce a separate pay spine for nursing.

Evidence submitted through the separate nurse pay spine call for evidence highlighted that career progression issues relating to the pay system do not uniquely impact nurses.We have therefore accepted several recommendations from workstreams committed to in the 2023 Agenda for Change (AfC) pay deal, which focus on ensuring all AfC staff are in the correct pay band, as well as specific measures to improve career progression for nurses. We have also committed to providing the NHS Staff Council with a funded mandate to address issues with the pay structure.

By what date he expects the NHS to have a virtual ward capacity of 40 beds per 100,000 people.

The NHS England 2025/26 priorities and operational planning guidance asks systems to improve access to urgent care services, including virtual ward, also known as hospital at home, services.No national population target has been set centrally for 2025/26 and it is for local systems to take decision on how best to increase capacity and utilisation as part of the range of urgent care services that can be accessed locally. Progress has continued to be made, with 12,825 virtual ward beds open in March 2025 compared to 11,856 in March 2024.The Government is committed to transforming the National Health Service from analogue to digital, and this shift will be central to our 10-Year Health Plan.