Written questions by Darling.

What the average waiting time is for (a) ambulances held in queues and (b) people waiting at home for an ambulance.

The national average ambulance handover time was 43 minutes and 32 seconds in December 2024. The following table shows the national ambulance response time, including for people who have called for an ambulance from their home, for Category 1, 2, 3, and 4 incidents, in hours, minutes and seconds:Category of incidentDecember 2024 national averageNHS Constitution standardCategory 1 average response time00:08:4000:07:00Category 1 90th centile response time00:15:2500:15:00Category 2 average response time00:47:2600:18:00Category 2 90th centile response time01:41:4000:40:00Category 3 90th centile response time07:21:0302:00:00Category 4 90th centile response time08:15:4403:00:00Source: NHS England Ambulance Quality Indicators, which is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/

If he will set targets to reduce memory clinic waiting times in (a) Torbay, (b) Exeter and (c) Barnstaple.

The Government is committed to transforming diagnostic services, including the detection and diagnosis of dementia, and will support the National Health Service to increase capacity to meet the demand for diagnostic services. We are committed to improving dementia diagnosis rates and recovering them to the national ambition for two thirds of people with dementia to have a formal diagnosis.NHS England has funded an evidence-based improvement project to fund two trusts in each region, making 14 sites in total, to pilot the Diagnosing Advanced Dementia Mandate tool to improve the diagnosis of dementia and provision of support in care homes. All pilots completed at the end of May 2024, and it is anticipated that learning will be shared in early 2025.To support recovery of the dementia diagnosis rates and implementation of the Dementia Care Pathway, NHS England has developed a dashboard for management information purposes. The aim is to support commissioners and providers of memory services with appropriate data and enable targeted support where needed.

If he will issue guidance to integrated care boards on representation for NHS Primary Care stakeholders.

The Health and Care Act 2022 sets out the legislative minimum integrated care board (ICB) membership requirement, with a mandated partner member nominated for primary medical services, along with nominated partner members from the National Health Service trusts and local authorities to bring knowledge and a perspective from their sectors. ICBs can exceed the legislative minimum requirements for ICB membership to address local needs, which may include additional representation from a diverse range of stakeholders, including primary care. Currently there are no plans to issue any guidance on representation of NHS primary care stakeholders.

If his Department will make an assessment of the potential merits of bringing vision rehabilitation services under the same (a) regulatory and (b) monitoring regimes as other adult social care services.

I refer the hon. Member to the answer I gave to the hon. Member for Colne Valley on 4 October 2024 to Question 7299.

What data his Department holds on the provision of vision rehabilitation support in England.

The Department does not collect or hold this information.

If he will take steps to ensure that the fee paid to deliver the Special Schools Eye Care Service is not reduced so that (a) children with Special Educational Needs can receive free eye care in schools and (b) eye care professionals can afford to provide the service.

To address the access challenges that children and young people with learning disabilities or autism, or both, face in accessing high street sight testing services, regulations were laid on 28 November to support the roll out of sight testing in special educational setting across England. NHS England has committed to invest up to £12.7 million annually from 2024/25 on the provision of sight tests and associated optical vouchers in special educational settings. This represents an approximate 87% increase compared to previous levels of spending. This additional investment has the potential to increase coverage from 4% of special educational settings to 100%. NHS England has held a number of recent engagement events with potential providers across the country, and there has been healthy interest so far. NHS England will continue to engage with key stakeholders, including the ophthalmic and voluntary sector, and provide support to local integrated care boards, in the roll out of the service.

What steps he is taking to address eye care inequalities for adults with learning disabilities.

Alongside the duty placed upon integrated care boards to reduce inequalities, regulations were laid on 28 November to support the roll out of sight testing services in special educational settings across England, which has the potential to reach approximately 165,000 children and young people with learning disabilities or autism, or both.We are also working with NHS England to better integrate primary and secondary care services, and improve the referral, triage, and access to appropriate care for all patients. As part of this work, NHS England has conducted research to understand the experience of adults with learning disabilities in accessing eye care services, the intelligence from which will be used to inform future policy design.

If he will make a decision on the funding of Torbay Hospital under the New Hospital Programme before 31 December 2024.

The Torbay and South Devon NHS Foundation Trust is currently developing their Strategic Outline Case for the new Torbay Hospital scheme. Following review and agreement of the Strategic Outline Case, the next step would be the development, review, and agreement of the Outline and Full Business Cases. Through this process, the final funding amount is determined, as is usual for large infrastructure projects.Torbay Hospital is in scope of the review into the New Hospital Programme. My Rt. Hon. Friend, the Secretary of State for Health and Social Care, will set out further details of the outcome of the review at the earliest opportunity, alongside a new delivery schedule for the programme.

When he plans to make a decision on funding for the Family Hubs and Start for Life programme beyond 31 March 2025.

The Family Hubs and Start for Life programme is central to the Government’s commitments to give every baby the best start in life, and to deliver the healthiest generation of children ever.The Government recognises the importance of providing local authorities with certainty of future funding across the Family Hubs and Start for Life programme. The Autumn Budget announcement included £69 million to continue delivery of a network of Family Hubs in 2025/26. The Department will confirm Start for Life funding in due course.

If he will have discussions with NICE on the potential merits of offering Paxlovid to people over the age of 50.

Decisions on whether licensed medicines should be recommended for routine National Health Service funding are made independently by the National Institute for Health and Care Excellence (NICE), on the basis of the evidence of the costs and benefits. The Department has no plans to speak to the NICE about offering Paxlovid to all people over the age of 50 years old.NICE guidance recommends Paxlovid, which contains nirmatrelvir and ritonavir, as an option for treating COVID-19 in adults only if they do not need supplemental oxygen for COVID-19 and if they are or have any of the following:an increased risk for progression to severe COVID-19, as defined in the guidance;are aged 70 years old and over;a body mass index of 35 kilograms per meter squared of height, or more;diabetes; orheart failure.The NICE has agreed to NHS England’s proposal to a phased implementation of its recommendations on Paxlovid, to allow more time for the NHS to put in place the capacity and infrastructure needed for full rollout to all eligible patients. Paxlovid is currently available to NHS patients at highest risk of severe COVID-19, in line with the approach to the rollout set out in the NICE’s guidance.

What steps his Department is taking to improve accident and emergency services at Torbay Hospital.

The Government has committed to supporting the National Health Service to improve performance across the country, including in Torbay. This includes returning to the standard set out in the NHS Constitution, that 95% of patients attending accident and emergency departments are admitted, transferred, or discharged within four hours.Torbay hospital is part of the New Hospital Programme, with plans including delivery of a new emergency department at the hospital.

What recent discussions his Department has had with NICE on reducing the time taken for patients to access treatment for very rare diseases in cases when there is uncertainty on the (a) incidence and (b) prevalence of the disease.

The Department has regular discussions with the National Institute for Health and Care Excellence (NICE) about a range of issues, including in relation to timelines for appraisals. The NICE aims to issue draft guidance on new medicines, including for rare diseases, as close to the time of licensing as possible.

Whether he plans to increase the number of healthcare professionals trained to (a) diagnose and (b) treat Charles Bonnet Syndrome.

Patients who experience Charles Bonnet symptoms who are already under hospital eye services can access support services via an Eye Care Liaison Officer within the hospital. Otherwise, a patient should contact their general practice (GP). The GP will make sure that the patients is not suffering hallucinations for any other reason, and then refer them directly to local Low Vision Services, which will incorporate support for Charles Bonnet Syndrome.Healthcare professionals are responsible for ensuring their clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development.

Whether his Department is taking steps to establish a formal pathway for the (a) diagnosis and (b) treatment of Charles Bonnet Syndrome.

Patients who experience Charles Bonnet symptoms who are already under hospital eye services can access support services via an Eye Care Liaison Officer within the hospital. Otherwise, a patient should contact their general practice (GP). The GP will make sure that the patients is not suffering hallucinations for any other reason, and then refer them directly to local Low Vision Services, which will incorporate support for Charles Bonnet Syndrome.Healthcare professionals are responsible for ensuring their clinical knowledge remains up-to-date and for identifying learning needs as part of their continuing professional development.

If he will make an assessment with Cabinet colleagues of the potential impact of providing auditory verbal therapy to deaf young children on (a) their employment prospects and (b) other outcomes.

I refer the hon. Member to the answer I gave to the hon. Member for Washington and Gateshead South on 14 October 2024 to Question 5963.

What estimate he has made of the number of NHS employees who have (a) taken early retirement and (b) had their employment terminated as a result of long covid, by region.

No such estimate has been made by the Department.

If he will publish a regional breakdown of the supply chain issues with Creon.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information is not collected on a local level.The Department has been working with suppliers to address current supply issues with Creon, which is used by patients with conditions such as cystic fibrosis and certain cancers, including pancreatic cancer. The supply issues with Creon are impacting countries throughout Europe and have been caused by limited availability of raw ingredients and manufacturing capacity constraints to produce the volumes needed to meet demand. These issues have resulted in knock-on supply disruptions of alternative pancreatic enzyme replacement therapy (PERT) medications. The Department is continuing to work with all suppliers of PERT to help resolve the supply issues in the short and longer term. This includes asking that they expedite deliveries, source stock from other markets, and increase production.The supplier of Creon has advised that they expect to have regular supplies released each month going forward, and are working to increase the quantities released. Serious Shortage Protocols are in place for Creon 10,000 and 25,000 capsules which pharmacists can use to restrict supply to one month at a time to ensure more patients have access to it whilst stock is limited.We have worked closely with colleagues in NHS England to issue comprehensive guidance to healthcare professionals about these supply issues, and encourage sharing of local solutions. The guidance provides advice on how to manage patients whilst there is disruption to supply and is being kept under review, with updates made as necessary.

What assessment he has made of the level of variation in funding hospices receive across England.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care, including hospices, will have a big role to play in that shift.Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life and their loved ones.No assessment has been made on the level of variation of hospice funding. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth and range of palliative and end of life care provision within their ICB footprint.

Whether he plans to reform the funding model for charitable hospices as part of the 10 year plan for health and care.

We have committed to develop a 10-Year Health Plan to deliver an NHS fit for the future, by driving three shifts in the way health care is delivered, specifically: moving healthcare from hospital to the community; from analogue to digital; and from sickness to prevention. We will carefully consider policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders, including those in the hospice sector, as we develop the plan.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services.  The amount of funding charitable hospices receive varies by integrated care board (ICB) area, and will, in part, be dependent on the breadth of palliative and end of life care provision within each ICB catchment area.I recently met with NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care in England.  We will consider next steps on palliative and end of life care, including hospice funding, in the coming months.

Whether his Department has made an assessment of the impact of hospice funding on people's experiences of death and dying.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and hospices will have a big role to play in that shift.Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at end of life, as well as their loved ones.No assessment has been made of the impact of hospice funding on people’s experiences of death and dying. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth and range of palliative and end of life care provision within their ICB footprint.