Written questions by Darling.

What steps his Department is taking to expand the use of community optometry services.

Integrated care boards are responsible for assessing the health needs of their local population and commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services.NHS England’s accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What assessment his Department has made of the adequacy of the regional provision of Minor Eye Conditions Services.

Integrated care boards are responsible for assessing the health needs of their local population and commissioning primary and secondary eye care services to meet them. This can include the commissioning of enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services.NHS England’s accelerator pilots have demonstrated that improved IT connectivity and a single point of access can significantly speed up eye care referrals and support more patients to be managed in the community, in line with the ambitions in the 10-Year Health Plan.

What assessment he has made of the potential impact of the Wait 45 policy for ambulance wait times, including on corridor care and patients being looked after in sub-optimal areas.

NHS England continues to regularly monitor trust performance.We are tackling unacceptable ambulance handover delays by introducing a maximum 45-minute standard, supporting the quicker release of ambulances, helping them get back on the road to treat patients. These delays should be recognised as a system wide responsibility and effective collaboration between ambulance services, acute trusts, integrated care boards, and other providers is required.Nationally, we have seen average handover delays fall to 31 minutes 19 seconds in October compared to 40 minutes 20 seconds in October 2024. This reflects the improvements in Category 2 response times to 32 minutes 37 seconds from 42 minutes 15 seconds over the same time period.We are also committed to ending corridor care. When Release to Rescue is implemented, ambulance trusts must put in place robust patient protection measures. Patients should only be cared for in temporary escalation spaces when all other options are exhausted, and this must not become standard practice.Our Urgent and Emergency Care Plan set out steps we are taking to improve accident and emergency waiting times, including the commitment to publish data on the prevalence of corridor care. The data quality is currently being reviewed, and the information will be published shortly.

What the selection criteria was for the location of the 43 new neighbourhood hubs.

We have launched wave 1 of the National Neighbourhood Health Implementation Programme (NNHIP) in 43 places across England, including Cornwall and the Isle of Scilly.This is a large-scale change programme for all partners involved in delivering neighbourhood health, including the National Health Service, local government, social care providers, other statutory and non-statutory organisations and the voluntary sector. There is a strong focus on co-production and working with the people and communities they serve, and taking a ‘test, learn and grow’ approach in line with the wider public sector reform agenda.We had an overwhelming response to the NNHIP, receiving 141 applications, which is approximately 83% of the number of places in England. Given the large volume of high-quality applications, selecting sites for wave 1 was not an easy task.Selection was carried out in line with usual NHS England processes, with all applicants assessed against consistent criteria. This includes demonstrating strong integrated working, clear readiness to participate, robust governance and data sharing arrangements, and a focus on areas with the greatest need.Work is underway to consider the future direction of the NNHIP, and we will share an update on this as soon as we can.

What estimate he has made of the (a) number of patients in Torbay NHS Foundation Trust who had no criteria to reside but who were not discharged by the end of the day and (b) what proportion of acute day beds this entails in each of the last seven days.

Data on the daily number of patients who no longer meet the criteria to reside is published monthly by NHS England, and is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/discharge-delays/acute-discharge-situation-report/In addition, monthly average figures for the number of general and acute beds are published by NHS England, and are available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/critical-care-and-general-acute-beds-urgent-and-emergency-care-daily-situation-reports/For the Torbay and South Devon NHS Foundation Trust, there were on average 34 adult patients each day in October 2025 who had no criteria to reside but who were not discharged by the end of the day.The following table shows the proportion of acute beds occupied by patients with no criteria to reside but who had not been discharged for the last seven days of October 2025, during which time there were an average of 385 adult general and acute beds available, for the Torbay and South Devon NHS Foundation Trust:DateNumber of patients remaining in hospital who no longer meet criteria to resideProportion of adult general and acute beds occupied by patients with no criteria to reside25/10/2025298%26/10/2025277%27/10/20253710%28/10/2025318%29/10/2025349%30/10/20253910%31/10/2025339%

What steps his Department is taking to monitor (a) cases of (i) parasitic infections and (ii) chemical sensitisation and (b) infection rates associated with poor hygiene practices in nail and beauty salons.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

Whether his Department has considered adopting (a) mandatory sterilisation equipment, (b) spot checks, (c) minimum qualification standards and (d) other international best practices for nail and beauty salons.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

What assessment his Department has made of the potential impact of low-cost, unregulated online beauty courses on (a) public safety and (b) professional standards.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

What steps his Department is taking to ensure that (a) training and (b) accreditation for nail and beauty professionals reflect modern (i) hygiene and (ii) safety standards.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

Whether his Department has considered the introduction of (a) mandatory hygiene protocols and (b) licensing requirements for nail and beauty salons.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

Whether his Department has made a comparative assessment of the regulation of nail and beauty salons in (a) the UK and (b) other European countries.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

Whether his Department plans to (a) review and (b) update the national (i) curriculum and (ii) accreditation frameworks for nail and beauty qualifications.

Nail and beauty salons are already required to comply with various legislation depending on the services they offer. This includes the Health and Safety at Work etc. Act 1974 and other legislation such as the Management of Health and Safety at Work Regulations 1999 and the Control of Substances Hazardous to Health Regulations 2002. This legislation requires that operators ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and that their clients are not exposed to risks to their health and safety.The Government is committed to addressing longstanding concerns around the safety of the cosmetics sector. On 7 August we announced our plans to introduce further regulation in this space. As part of this work the Government has committed to legislating to introduce a licensing scheme for non-surgical cosmetic procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed.The consultation response sets out that, in the first instance, the Government will prioritise the introduction of legal restrictions to ensure that cosmetic procedures that are deemed to pose the highest level of risk to the public, such as the liquid Brazilian butt lift, are classed as Care Quality Commission (CQC) regulated activities. This will mean that these procedures will only be performed by suitably qualified regulated healthcare professionals, working for providers who are registered with the CQC.We will subsequently take forward work to determine which procedures will be included within the scheme and what requirements will have to be met in order to be granted a licence. This includes requirements relating to training and qualification standards and infection prevention and control measures. We are working with a range of stakeholders to better understand the risks posed by unsafe practice and to ensure the design of the licensing scheme addresses these safety concerns. To help inform this work, we will consider what relevant systems and standards are already in place, both in the United Kingdom and overseas.

With reference to his Department's plan Fit for the Future: 10 Year Health Plan for England, when he plans to publish more information about the intended reforms to the Better Care Fund.

As set out in the 10-Year Health Plan and in the 2025/26 Better Care Fund policy framework, we will reform the Better Care Fund from the 2026/27 financial year. An announcement with further detail on this reform will be made in due course.

With reference to his Department's plan Fit for the Future: 10 Year Health Plan for England, whether the plans to reform the Better Care Fund will impact on the level of funding intended to support unpaid carers in future financial years.

As set out in the 10-Year Health Plan and the 2025/26 Better Care Fund policy framework, we will reform the Better Care Fund from financial year 2026/27. An announcement with further detail on this reform will be made in due course. The reform will not impact on the level of funding intended to support unpaid carers in future financial years.In 2025/26, health and wellbeing boards were asked what the primary objective of each scheme was. In England, £222,515,273 was allocated to schemes with the primary objective of supporting unpaid carers. Primary objectives were not requested in previous years for comparison.Health and wellbeing boards are also asked to record information on scheme types. The most appropriate scheme type in 2025/26 was support to carers, including unpaid carers, which has a planned spend of £201,223,000. In previous years, the most appropriate scheme type was carers services. The following table shows the total planned spend on carers services for 2022/23, 2023/24, and 2024/25:YearTotal planned spend on carers services2022/23£156,863,0082023/24£211,660,3712024/25£216,884,174 There are no sub types for planned spend on unpaid family carers or short breaks. In 2022/23, £86,394,455, or 55%, of the total planned spend on carers services was spent on the sub type respite.Information on scheme types for carers broken down by health and wellbeing board has been published and is available for the year 2025/26 and for the years 2023 to 2025, respectively, at the following two links:https://www.england.nhs.uk/publication/better-care-fund-2025-26-planning-data/https://www.england.nhs.uk/publication/better-care-fund-2023-to-2025-planning-data/

What was the cost to the public purse of supporting unpaid carers in England through the Better Care Fund in each of the last three financial years.

As set out in the 10-Year Health Plan and the 2025/26 Better Care Fund policy framework, we will reform the Better Care Fund from financial year 2026/27. An announcement with further detail on this reform will be made in due course. The reform will not impact on the level of funding intended to support unpaid carers in future financial years.In 2025/26, health and wellbeing boards were asked what the primary objective of each scheme was. In England, £222,515,273 was allocated to schemes with the primary objective of supporting unpaid carers. Primary objectives were not requested in previous years for comparison.Health and wellbeing boards are also asked to record information on scheme types. The most appropriate scheme type in 2025/26 was support to carers, including unpaid carers, which has a planned spend of £201,223,000. In previous years, the most appropriate scheme type was carers services. The following table shows the total planned spend on carers services for 2022/23, 2023/24, and 2024/25:YearTotal planned spend on carers services2022/23£156,863,0082023/24£211,660,3712024/25£216,884,174 There are no sub types for planned spend on unpaid family carers or short breaks. In 2022/23, £86,394,455, or 55%, of the total planned spend on carers services was spent on the sub type respite.Information on scheme types for carers broken down by health and wellbeing board has been published and is available for the year 2025/26 and for the years 2023 to 2025, respectively, at the following two links:https://www.england.nhs.uk/publication/better-care-fund-2025-26-planning-data/https://www.england.nhs.uk/publication/better-care-fund-2023-to-2025-planning-data/

How much Better Care Fund funding has been provided to each health and wellbeing board to support unpaid carers in each of the last three financial years.

As set out in the 10-Year Health Plan and the 2025/26 Better Care Fund policy framework, we will reform the Better Care Fund from financial year 2026/27. An announcement with further detail on this reform will be made in due course. The reform will not impact on the level of funding intended to support unpaid carers in future financial years.In 2025/26, health and wellbeing boards were asked what the primary objective of each scheme was. In England, £222,515,273 was allocated to schemes with the primary objective of supporting unpaid carers. Primary objectives were not requested in previous years for comparison.Health and wellbeing boards are also asked to record information on scheme types. The most appropriate scheme type in 2025/26 was support to carers, including unpaid carers, which has a planned spend of £201,223,000. In previous years, the most appropriate scheme type was carers services. The following table shows the total planned spend on carers services for 2022/23, 2023/24, and 2024/25:YearTotal planned spend on carers services2022/23£156,863,0082023/24£211,660,3712024/25£216,884,174 There are no sub types for planned spend on unpaid family carers or short breaks. In 2022/23, £86,394,455, or 55%, of the total planned spend on carers services was spent on the sub type respite.Information on scheme types for carers broken down by health and wellbeing board has been published and is available for the year 2025/26 and for the years 2023 to 2025, respectively, at the following two links:https://www.england.nhs.uk/publication/better-care-fund-2025-26-planning-data/https://www.england.nhs.uk/publication/better-care-fund-2023-to-2025-planning-data/

If he will publish the evaluation commissioned by the National Institute for Health and Care Research on support for unpaid carers funded through the Better Care Fund undertaken in 2023-24.

The Department funds independent research through its research delivery arm, the National Institute of Health and Care Research (NIHR). This project is funded through the NIHR Policy Research Programme.The research undertaken in 2023/24 was a development phase, which is the preparatory stage for a larger research project, with findings available at the following link:https://www.lse.ac.uk/cpec/assets/documents/CPEC-Briefing-Note-2-Support-for-unpaid-carers.pdfThe second phase of the evaluation is ongoing. Findings from the second phase will be made publicly available after research is completed in July 2028.The publication of research is led by the research team and in line with NIHR commitments to the transparent and independent publication of high-quality research. The views expressed in research outputs are those of the authors and not necessarily those of the NIHR or the Department.

How much and what proportion of the Better Care Fund will be spent on supporting unpaid family carers in the 2025-26 financial year; and how much was provided for (a) short breaks and (b) respite for carers in the 2022-23 financial year.

As set out in the 10-Year Health Plan and the 2025/26 Better Care Fund policy framework, we will reform the Better Care Fund from financial year 2026/27. An announcement with further detail on this reform will be made in due course. The reform will not impact on the level of funding intended to support unpaid carers in future financial years.In 2025/26, health and wellbeing boards were asked what the primary objective of each scheme was. In England, £222,515,273 was allocated to schemes with the primary objective of supporting unpaid carers. Primary objectives were not requested in previous years for comparison.Health and wellbeing boards are also asked to record information on scheme types. The most appropriate scheme type in 2025/26 was support to carers, including unpaid carers, which has a planned spend of £201,223,000. In previous years, the most appropriate scheme type was carers services. The following table shows the total planned spend on carers services for 2022/23, 2023/24, and 2024/25:YearTotal planned spend on carers services2022/23£156,863,0082023/24£211,660,3712024/25£216,884,174 There are no sub types for planned spend on unpaid family carers or short breaks. In 2022/23, £86,394,455, or 55%, of the total planned spend on carers services was spent on the sub type respite.Information on scheme types for carers broken down by health and wellbeing board has been published and is available for the year 2025/26 and for the years 2023 to 2025, respectively, at the following two links:https://www.england.nhs.uk/publication/better-care-fund-2025-26-planning-data/https://www.england.nhs.uk/publication/better-care-fund-2023-to-2025-planning-data/

If he will consider extending access to cardiac screening to people aged 14 to 35 who participate in sport.

In the United Kingdom, national screening programmes are introduced based on the recommendations of the UK National Screening Committee (UK NSC), an independent scientific advisory committee which advises ministers and the National Health Service in all four countries on all aspects of population and targeted screening and which supports implementation.The UK NSC last reviewed screening for sudden cardiac death (SCD) in people under the age of 39 years old in 2019 and concluded that population screening should not be offered. Further information is available at the following link:https://view-health-screening-recommendations.service.gov.uk/sudden-cardiac-death/The UK NSC is currently examining the evidence for SCD screening and will open a public consultation to seek comments from members of the public and stakeholders on this in due course.

What assessment he has made of the potential impact of the Wait 45 policy on (a) ambulance release times and (b) levels of corridor care in hospitals.

The Department has not made a specific assessment. However, ambulance handover delays have improved since last year, and monthly average national handover times have been under 30 minutes since May 2025.As part of the preparations for winter, the Department and NHS England have asked all services to develop and test winter plans, including specific actions to improve flow through hospitals and making progress on eliminating corridor care.