Written questions by Braverman.

Whether his Department has considered implementing routine screening for Type 1 diabetes in children.

A National Institute for Healthcare Research funded the EarLy Surveillance for Autoimmune diabetes, or ELSA, study, which is currently underway in England to explore the feasibility and benefits of screening for type 1 diabetes in children aged three to 13 years old.The UK National Screening Committee, which advises ministers on all aspects of population and targeted screening, is aware of the ELSA study and looks forward to receiving the results of this study when the trial is complete.

What steps his Department is taking to improve public (a) awareness and (b) education on (i) epilepsy and (ii) Sudden Unexpected Death in Epilepsy.

National Institute for Health and Care Excellence (NICE) guidance on epilepsy recommends that clinicians should discuss the risk of Sudden Unexpected Death in Epilepsy (SUDEP) with patients newly diagnosed with epilepsy, and ensure their understanding of the risk, which will raise awareness of the issue among patients and their families.Additionally, the Royal College of General Practitioners aims to raise awareness of SUDEP amongst GPs and other primary care professionals, through its e-learning modules on SUDEP and seizure safety, which were developed in collaboration with SUDEP Action and last updated in December 2024.Health Education England, now part of NHS England, has also developed an Epilepsy Programme in collaboration with SUDEP Action, which is designed to enable healthcare professionals, particularly those who are not specialists in epilepsy, to better understand SUDEP and how the risk of SUDEP can be reduced.

What assessment his Department has made of the potential impact of levels of epilepsy medication availability on patient safety.

Medicine supply issues are global in their nature and, whilst not wholly preventable, the Department has a range of well-established processes and tools to manage and mitigate risks to patients. The Department has worked hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including asking manufacturers to expedite deliveries, most issues have been resolved.The Department is currently aware of supply issues affecting some suppliers of clobazam 10 milligram tablets, all strengths of topiramate tablets, clonazepam 2 milligram tablets, and phenobarbital 15 milligram tablets, used in the management of epilepsy.The supply issue with clonazepam 2mg tablets from one manufacturer is expected to resolve late January 2026. The affected suppliers of topiramate 25 milligram and 50 milligram tablets, and clobazam 10 milligram tablets, are expected to resupply these products by early December 2025. The resupply date from the other affected manufacturers for topiramate 50 milligram, 100 milligram and 200 milligram tablets and phenobarbital 15 milligram tablets is yet to be confirmed. Stock remains available from alternative manufacturers of these products to meet patient demand, and we have issued comprehensive management guidance to the National Health Service.We have issued guidance for the discontinuation of sodium valproate (Epilim Chronosphere) 750 milligram and 1000 milligram modified release (MR) granules sachets. Alternative strengths of sodium valproate MR granules sachets remain available.

Whether he plans to introduce mandatory epilepsy training for (a) employers and (b) employees.

Employers have a key role to play in supporting workers with long-term health conditions or disabilities in the workplace and it is for employers to assess the training requirements for their workforce. However, the Department of Health and Social Care has no plans to introduce mandatory epilepsy training.The Department for Work and Pensions’ current offer to employers includes a digital information service which provides tailored guidance to businesses to support employees, including epileptic employees, to remain in work.The service was developed with user-centred design principles. It offers a simple, interactive, and highly usable resource which helps employers to feel more confident having conversations with their employees about health and disability as well as understanding and fulfilling their legal obligations.This digital service provides tailored guidance on supporting employees in common workplace scenarios involving health and disability. This enables small businesses to self-serve, by guiding them through key processes. Employers are also able to access links to related government products and services as well as links to sources of external expert support including Epilepsy Action and Epilepsy Society.The digital information service is available at the following link:https://www.support-with-employee-health-and-disability.dwp.gov.uk/support-with-employee-health-and-disability

If he will publish a national strategy for palliative and end of life care.

The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via integrated care boards. This amounts to approximately £80 million over the next three years.

What steps NHS England is taking to ensure continuity of care for children with rare or complex conditions when accessing frontline NHS services.

We are committed to supporting children with long term conditions and ensuring they receive the support they need, including referral to specialist services as appropriate. We want a society where every person, including those with a long-term condition, as well as their families and carers receive high-quality, compassionate continuity of care.Working under the UK Rare Diseases Framework the Government is committed to improving the lives of those living with rare diseases. The framework’s priorities include better coordination of care and increasing awareness of rare diseases among healthcare professionals, including in primary care. We remain committed to delivering under the framework and published the fourth England action plan on 28 February 2025.

Whether NHS England collects data on outcomes for children with congenital heart conditions who are treated in non-specialist settings.

The specific information requested is not held centrally. Information related to the outcomes for children with congenital heart conditions is available through the National Congenital Heart Disease Audit Annual Summary Report. The report does not disaggregate by non-specialist service.

What steps his Department is taking to improve training for General Practitioners and junior doctors in recognising and managing cardiac and respiratory vulnerabilities in paediatric patients.

The steps taken include the production of the Paediatric and child health advanced practice area specific capability and curriculum framework, which was co-produced by NHS England and the Royal College of Paediatrics and Child Health. The framework is available at the following link:https://advanced-practice.hee.nhs.uk/wp-content/uploads/sites/28/2025/01/Paediatric-and-child-Health-advanced-practice-area-specific-capability-and-curriculum-framework-NHSE.pdfThe framework outlines area specific capabilities and a curriculum addressing the full spectrum of paediatric health needs, including recognising and managing cardiac and respiratory conditions.

Whether NHS England plans to introduce standardised national protocols for interpreting oxygen saturation thresholds in children with chronic cardiac conditions.

The National Paediatric Early Warning System (NPEWS) was launched in England in November 2023. The use of NPEWS allows for a standard approach to recognition and escalation of concern when a child might be deteriorating. NPEWS works by assigning a score to varying levels of physiological values including oxygen saturations, depending on how far from normal those values are. Recent evaluation by the Liverpool DETECT study group has found that NPEWS predictive performance remained very good within cohorts of children with and without cardiac disease.

If his Department will make an assessment of the potential merits of reviewing the clarity of escalation pathways for parents of children with complex medical needs.

Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population. ICBs are expected to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, NICE published guidance on Disabled children and young people up to 25 with severe complex needs. This is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningNHS England is rolling out Martha’s Rule in acute provider sites, which gives in-patients and their families or carers who are concerned about physiological deterioration the ability to initiate a rapid review of their case from someone outside of their immediate care team. When requested, this rapid review will inform whether any new or additional action needs to be taken to ensure patients receive the most appropriate care and treatment, which may include escalation.

What assessment he has made of the potential impact of workforce levels on the ability of community pharmacies to meet service demands.

For 2025/26, funding for the core community pharmacy contractual framework was increased to £3.1 billion, in agreement with Community Pharmacy England, which represents all pharmacy contactors including independent pharmacies. This represented the largest uplift in funding of any part of the National Health Service at the time, namely over 19% across 2024/25 and 2025/26.The resilience of United Kingdom supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. On 15 August 2025, the Government published a policy paper, Managing a robust and resilient supply of medicines. We will continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other stakeholders across the supply chain as we progress work to co-design and deliver these actions. Regarding the pharmacy workforce, as private businesses pharmacy employers have a clear role to ensure staff levels are adequate to deliver commissioned NHS services. The annual community pharmacy workforce survey provides data on current workforce levels. The survey is an important tool to help inform workforce planning for employers and NHS integrated care boards. The Community Pharmacy Workforce Survey data is available at the following link:https://www.data.gov.uk/dataset/09aa8f38-547a-46b7-a117-2cb710ad939b/https-www-hee-nhs-uk-our-work-pharmacy-community-pharmacy-workforce-surveyWe will publish the 10 Year Workforce Plan by the end of 2025. This will look at how healthcare professionals can work at the top of their skills, and ask what workforce we need, what they should do, where they should be deployed and what skills they should have.To support pharmacy employers develop their staff and deliver quality NHS services, NHS England provides several fully funded national training opportunities for pharmacists and pharmacy technicians. This includes independent prescriber training, clinical examination skills, and training the next generation of education supervisors.

What recent discussions his Department has had with independent pharmacies on (a) funding, (b) supply chain reform and (c) workforce levels.

For 2025/26, funding for the core community pharmacy contractual framework was increased to £3.1 billion, in agreement with Community Pharmacy England, which represents all pharmacy contactors including independent pharmacies. This represented the largest uplift in funding of any part of the National Health Service at the time, namely over 19% across 2024/25 and 2025/26.The resilience of United Kingdom supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. On 15 August 2025, the Government published a policy paper, Managing a robust and resilient supply of medicines. We will continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other stakeholders across the supply chain as we progress work to co-design and deliver these actions. Regarding the pharmacy workforce, as private businesses pharmacy employers have a clear role to ensure staff levels are adequate to deliver commissioned NHS services. The annual community pharmacy workforce survey provides data on current workforce levels. The survey is an important tool to help inform workforce planning for employers and NHS integrated care boards. The Community Pharmacy Workforce Survey data is available at the following link:https://www.data.gov.uk/dataset/09aa8f38-547a-46b7-a117-2cb710ad939b/https-www-hee-nhs-uk-our-work-pharmacy-community-pharmacy-workforce-surveyWe will publish the 10 Year Workforce Plan by the end of 2025. This will look at how healthcare professionals can work at the top of their skills, and ask what workforce we need, what they should do, where they should be deployed and what skills they should have.To support pharmacy employers develop their staff and deliver quality NHS services, NHS England provides several fully funded national training opportunities for pharmacists and pharmacy technicians. This includes independent prescriber training, clinical examination skills, and training the next generation of education supervisors.

What assessment he has made of the adequacy of funding levels for community pharmacies.

The Government recognises that pharmacies are an integral part of the fabric of our communities. They provide an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.For 2025/26, funding for the core community pharmacy contractual framework was increased to £3.1 billion, in agreement with Community Pharmacy England. This represented the largest uplift in funding of any part of the NHS at the time, at over 19% across 2024/25 and 2025/26. Any future funding arrangements will be subject to Spending Review allocations to the Department and, as customary, consultation with Community Pharmacy England.

Whether his Department plans to introduce an updated long-term funding model for community pharmacies.

The Government recognises that pharmacies are an integral part of the fabric of our communities. They provide an easily accessible ‘front door’ to the National Health Service, staffed by highly trained and skilled healthcare professionals.For 2025/26, funding for the core community pharmacy contractual framework was increased to £3.1 billion, in agreement with Community Pharmacy England. This represented the largest uplift in funding of any part of the NHS at the time, at over 19% across 2024/25 and 2025/26. Any future funding arrangements will be subject to Spending Review allocations to the Department and, as customary, consultation with Community Pharmacy England.

Whether his Department is taking steps to formally recognise the contribution of community pharmacies to (a) NHS service delivery and (b) public health outcomes.

This Government has repeatedly publicly recognised the valuable contribution to the National Health Service that community pharmacy makes as an easily accessible ‘front door’ to the NHS, delivering a range of clinical services, providing access to medicine and supporting a range of public health outcomes.That is why we agreed to increase the community pharmacy contractual framework by £617 million across 2024/25 and 2025/26. This deal represents the largest uplift in funding of any part of the NHS, over 19% across 2024/25 and 2025/26, showing a commitment to rebuilding the sector.We have further recognised, in our 10-Year Health Plan, that we can better use the skills of community pharmacy teams by expanding the services they offer and ensuring their vital role is recognised as we develop Neighbourhood Health Services helping to deliver the shift of care from hospitals into the community.

What steps his Department is taking to reform the (a) procurement and (b) supply chain of medications to (i) ensure timely availability and (ii) reduce shortages at community pharmacies.

The resilience of UK supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages.As outlined in our recently published policy paper, ‘Managing a robust and resilient supply of medicines’, the Government is committed to building on the important actions already underway across the system to minimise disruption for patients and enhance resilience in our supply chains. The publication includes a number of actions, including:consulting on better reporting of supply issues;consulting on pharmacist flexibilities to allow pharmacists to supply an alternative if they do not have the exact prescribed item available, under certain circumstances;publishing information guides for patients, community pharmacies and general practices about what to do when faced with supply issues; andproviding shortage information at the point of prescribing in general practice.We will continue to engage with community pharmacy, industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver these actions.

Whether his Department plans to increase support for people with myalgic encephalomyelitis who are employed.

Occupational health as advisory support has a broad remit. It plays an important role in supporting employers to maintain and promote employee health and wellbeing through assessments of fitness for work, advice about reasonable adjustments, work ability or return to work plans, and signposting to treatment for specific conditions such as myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS).Access to Work is a demand-led, personalised discretionary grant that supports the recruitment and retention of disabled people in sustainable paid employment. The tailored nature of the scheme allows customers to receive the appropriate grant and support based on their specific health and disability-related needs, including ME/CFS. Access to Work grants do not replace an employer’s duty under the Equality Act 2010 to make reasonable adjustments.The goal is to open up opportunities to good work and to support a healthier, more productive and inclusive nation, by helping more disabled people and people with health conditions like ME/CFS to get appropriate work, get on in that work, and to return to work as quickly as possible if they leave it. This supports the Government’s priority of tackling economic inactivity, as set out in the Get Britain Working White Paper.NHS England recently completed a ME/CFS stocktake, aimed at providing a nationwide overview of service delivery in commissioning and contracting, assessing access, activity, and outcomes. The findings confirmed the widely recognised challenges of significant variation in care delivery across England and a lack of comprehensive activity data.We aim to publish our ME/CFS final delivery plan by the end of June 2025. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease. The responses to the interim delivery plan consultation, along with continued close engagement with other parts of the Government, the National Health Service, and external stakeholders, will inform the development of the final ME/CFS delivery plan.

Whether his Department has made an assessment of the adequacy of levels of support for people with myalgic encephalomyelitis.

Occupational health as advisory support has a broad remit. It plays an important role in supporting employers to maintain and promote employee health and wellbeing through assessments of fitness for work, advice about reasonable adjustments, work ability or return to work plans, and signposting to treatment for specific conditions such as myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS).Access to Work is a demand-led, personalised discretionary grant that supports the recruitment and retention of disabled people in sustainable paid employment. The tailored nature of the scheme allows customers to receive the appropriate grant and support based on their specific health and disability-related needs, including ME/CFS. Access to Work grants do not replace an employer’s duty under the Equality Act 2010 to make reasonable adjustments.The goal is to open up opportunities to good work and to support a healthier, more productive and inclusive nation, by helping more disabled people and people with health conditions like ME/CFS to get appropriate work, get on in that work, and to return to work as quickly as possible if they leave it. This supports the Government’s priority of tackling economic inactivity, as set out in the Get Britain Working White Paper.NHS England recently completed a ME/CFS stocktake, aimed at providing a nationwide overview of service delivery in commissioning and contracting, assessing access, activity, and outcomes. The findings confirmed the widely recognised challenges of significant variation in care delivery across England and a lack of comprehensive activity data.We aim to publish our ME/CFS final delivery plan by the end of June 2025. The plan will focus on boosting research, improving attitudes and education, and bettering the lives of people with this debilitating disease. The responses to the interim delivery plan consultation, along with continued close engagement with other parts of the Government, the National Health Service, and external stakeholders, will inform the development of the final ME/CFS delivery plan.

If he will take steps to help ensure that the Hampshire and Isle of Wight Integrated Care Board increases funding for Rowan's Hospice.

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. ICBs are responsible for commissioning palliative and end of life care services to meet the needs of their local populations.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 such as Rowan’s Hospice, also play in providing support to people at end of life and their loved ones.Most hospices, including Rowan’s Hospice, are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England to ensure they have the best physical environment for care. The Government has released the first £25 million tranche of the £100 million of capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. I am pleased that Rowan’s Hospice received £171,289 from this first tranche. An additional £75 million will be allocated in the coming weeks for use in 2025/26.

Whether his Department has made an assessment of the potential merits of increasing the the level of funding provided by Hampshire and the Isle of Wight Integrated Care Board to Rowan's hospice.

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. ICBs are responsible for commissioning palliative and end of life care services to meet the needs of their local populations.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 such as Rowan’s Hospice, also play in providing support to people at end of life and their loved ones.Most hospices, including Rowan’s Hospice, are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices in England to ensure they have the best physical environment for care. The Government has released the first £25 million tranche of the £100 million of capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. I am pleased that Rowan’s Hospice received £171,289 from this first tranche. An additional £75 million will be allocated in the coming weeks for use in 2025/26.