Written questions by Darling.

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.

If she will make an assessment of the potential merits of establishing a national A&E Appreciation Week.

The Government highly values hardworking National Health Service staff who go above and beyond to provide rapid and critical care. Local NHS trusts have in place their own approaches to recognising and rewarding staff, supported by advice and guidance set out in the Staff Recognition Framework. This is available at the following link:https://www.england.nhs.uk/long-read/staff-recognition-framework/Members of Parliament can also acknowledge the work of NHS staff in their constituency through the NHS Parliamentary Awards.

What assessment his Department has made of the (a) level and (b) nature of the challenges faced by A&E staff; and what additional support he is providing to boost A&E staff morale.

As set out in the 10-Year Health Plan, the Government is committed to making the National Health Service the best place to work, by supporting and retaining our hardworking and dedicated healthcare professionals, including those working in accident and emergency departments. The 10 Year Workforce Plan will set out how we will ensure that staff are better treated, have better training, and have more fulfilling roles.We will also work with the Social Partnership Forum to introduce a new set of staff standards for modern employment. The new standards will reaffirm our commitment to supporting staff by tackling the issues that matter to them. They will cover access to nutritious food and drink at work, reducing violence against staff, tackling racism and sexual harassment, standards of ‘healthy work’ and occupational health support, and support for flexible working. These standards will provide a framework for leaders across the NHS to build a supportive culture to help boost morale across the workforce.

What discussions he has had with NHS England on (a) the appointment of a single Chair for two different NHS Trusts and (b) ensuring that the effectiveness of those Trusts' (i) governance, (ii) accountability and (iii) local representation are not compromised by such arrangements.

The Government and NHS England support and expect collaboration between National Health Service trusts. Shared leadership, including having a shared chair, is one way which trusts can collaborate to address the issues they are facing.With any governance model they have in place, NHS trusts are required to meet the conditions in the NHS provider licence to ensure that organisations operate in a way that is safe, financially sustainable, cooperative, and accountable.Trusts can work with their regional NHS England teams to discuss potential shared leadership arrangements to ensure that governance and accountability remain effective, while realising the benefits of collaboration.

What assessment he has made of the adequacy of community care for dementia patients.

Provision of dementia health care services is the responsibility of local integrated care boards (ICBs). We expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence’s guidelines.Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services. We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity.The Modern Service Framework for Frailty and Dementia will seek to reduce unwarranted variation and narrow inequality for those living with dementia, will set national standards for dementia care and will redirect National Health Service priorities to provide the best possible care and support.

What assessment he has made of the potential merits of mandating standardised domestic abuse training for all frontline NHS staff.

It is the responsibility of National Health Service organisations to ensure that all staff undertake mandatory training on domestic abuse. Mandatory training at Level 1 is captured in the NHS Electronic Staff Record (ESR), as part of the integrated safeguarding training module. This is monitored by the Care Quality Commission as part of their provider compliance visit. Level 2 and 3 are stand-alone modules and are not always captured in the ESR. Staff are also required to undertake further domestic abuse training where it is relevant to their role.National mandatory safeguarding training for all NHS staff is being strengthened for launch in early 2026. This will reinforce the safeguarding responsibilities of staff and will support them in identifying and responding to victims of abuse.

What assessment he has made of the adequacy of his Department's provision of care for dementia patients within the local community.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Health Year Plan, those living with dementia will benefit from improved care planning and better services.We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in the quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.The Frailty and Dementia Modern Service Framework will seek to reduce unwarranted variation and narrow inequality for those living with dementia, and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.To reduce variation in diagnosis rates, the Office for Health Improvement and Disparities’ Dementia Intelligence Network has developed a tool for local systems, which includes an assessment of population characteristics such as rurality and socio-economic deprivation. This enables systems to investigate local variation in diagnosis and take informed action to enhance their diagnosis rates. The tool has been released and is available via the NHS Futures Collaboration platform.

What steps he is taking to make the NHS more accessible for people with hearing impairment.

Under the Equality Act (2010), health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged.The Reasonable Adjustment Digital Flag was developed to enable health and care workers to record, share, and view details of reasonable adjustments, across the National Health Service and social care, wherever the person is seen or treated.Since 2016, all NHS organisations and publicly funded social care providers are expected to meet the Accessible Information Standard, which details the recommended approach to supporting the information and communication support needs of people with a disability, impairment, or sensory loss, including people with a hearing or visual impairment.On 30 June 2025, a revised Accessible Information Standard (AIS) was published. NHS England is working to support implementation of the AIS with awareness raising, communication, and engagement, and is reviewing the current e-learning modules on the AIS. The intention is to ensure that staff and organisations in the NHS are aware of the AIS and the importance of meeting the information and communication needs of disabled people using services.