Written questions by Braverman.

Whether his Department has made an assessment of the effectiveness of local health authorities appeals process as a means to secure additional funding for charitable hospices.

Integrated care board (ICBs) are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. ICBs receive funding via their annual core allocation for resources. This is their recurrent budget which is uplifted and adjusted for their population on an annual basis. It is for ICBs to locally determine the utilisation of their core allocation, including funding for all healthcare, according to their assessment of the relevant healthcare needs of their population. It will be through this process that decisions regarding funding for hospices are made.Whilst the majority of palliative care 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. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services.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, and £26 million of revenue funding to support children and young people’s hospices.

Whether his Department has made an estimate of the cost of hiring new staff due to changes in employer National Insurance contributions for GP practices in Hampshire.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025. General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services. We are investing an additional £889 million in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

What steps his Department plans to take to improve the integration of charity hospices into the National Health System.

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 palliative and end of life care services, 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 the end of life and their loved ones.Most hospices 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, and £26 million of revenue funding to support children and young people’s hospices.In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.

What steps his Department plans to take to ensure that hospices receive adequate funding from local health authorities.

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 palliative and end of life care services, 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 the end of life and their loved ones.Most hospices 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, and £26 million of revenue funding to support children and young people’s hospices.In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.

What recent estimate his Department has made of the number of GP practices that will be affected by changes to National Insurance announced at the Autumn Budget 2024.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance (NI) rise was implemented in April 2025.General practices are valued independent contractors and will therefore be subject to the employers’ NI rise. Every year, we consult with the profession about what services general practice provides, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services.We are investing an additional £889 million in general practice to fix the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the England General Practitioners’ Committee of the British Medical Association is supportive of the contract changes

Whether his Department has made an assessment of the potential impact of changes to National Insurance announced at the Autumn Budget 2024 on the expansion of (a) GP practices and (b) other care provision.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025.General practices (GPs) are valued independent contractors who provide over £13 billion worth of services within the National Health Service. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services.We are investing an additional £889 million in GPs to fix the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the England General Practitioners Committee of the British Medical Association is supportive of the contract changes.

Whether his Department has made an assessment of the potential impact of changes to employer National Insurance contributions on social care providers who rely on charitable donations.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process.To enable local authorities to deliver key services such as adult social care, the Government has made available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant. Overall, core local government spending power in 2025/26 has increased by up to 6.8% in cash terms.

Whether his Department has made an assessment of the potential impact of changes to employer National Insurance contributions on the integration of social care providers into the National Health Service.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024.To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

Whether his Department has conducted a cost analysis for GP practices impacted by changes to employer National Insurance contributions.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025. General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services. We are investing an additional £889 million in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

Whether his Department has made an estimate of the average cost of changes to employer National Insurance contributions to individual GP practices.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025. General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services. We are investing an additional £889 million in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.

What steps his Department is taking to ensure that numbers of (a) GP surgeries and (b) staff working in those surgeries are not adversely impacted by changes to employer National Insurance contributions.

We have made the necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise was implemented in April 2025.General practices (GPs) are valued independent contractors who provide over £13 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services.We are investing an additional £889 million in GPs to fix the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade, and we are pleased that the General Practitioners Committee England is supportive of the contract changes.As commissioners of primary care, integrated care boards are responsible for ensuring that there is suitable provision of GP services to meet the needs of their local population. Practices close for a variety of reasons, including mergers or retirement, and so closures do not necessarily indicate a reduction in the quality of care. When a practice does close, patients are informed of the closure and advised to register at another local practice of their choice within their area.The Government committed to recruiting over 1,000 recently qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to address GP unemployment and secure the future pipeline of GPs. Data on the number of recently qualified GPs for which primary care networks are claiming reimbursement via the ARRS was published by NHS England on 7 April, showing that since 1 October 2024, 1,503 GPs were recruited through the scheme.

If he will make an assessment of the adequacy of waiting times for NHS Pension Scheme queries.

NHS Pension Scheme queries can be raised with the NHS Pension Scheme administrator, the NHS Business Services Authority (NHSBSA), and in the case of general practitioners (GPs), with Primary Care Support England (PCSE), who record GPs’ pensionable service and collect pension contributions.The NHSBSA reported that in March 2025, for general queries, the average speed for a call to be answered was 173 seconds, and the average response time for emails was 0.6 days. Further information about processing times for payments, estimates, transfers, and general queries received in writing is available at the following link:https://www.nhsbsa.nhs.uk/current-processing-times-nhs-pensionsThe pension queries received by PCSE are often complex and could involve records of GP service over multiple years, and can require working with the GP and other parties to resolve. PCSE’s services are contracted to Capita Business Services Ltd under a contract held by NHS England. NHS England has governance in place to oversee the performance of that contract, which includes monitoring the handling of queries and complaints. There are governance arrangements in place involving NHS England, PCSE, and NHS Pensions, to oversee the end-to-end service and identify areas for further improvement.

What assessment he has made of the adequacy of the level of modernisation of Primary Care Support England's NHS Pensions Scheme processes.

Primary Care Support England (PCSE) follows the pension scheme requirements laid down by NHS Pensions. PCSE has provided an online portal, PCSE Online, which provides general practitioners (GPs), practices, and commissioners with a simple and efficient way to manage pension payments and provide visibility on the information held by PCSE in relation to their pension. PCSE Online enables GPs and non-GP partners to determine if their pension details held by PCSE are correct, identify any gaps, and gives them the ability to self-serve a number of administrative tasks, including submitting end-of-year pension certificates. PCSE draws information from PCSE Online to update the pension scheme records of GPs held by NHS Pensions.

What steps he is taking to monitor (a) PCSE and (b) Capita's performance in managing the NHS Pension Scheme.

The NHS Business Service Authority is the scheme manager for NHS Pensions. NHS England is the employing authority for general practitioners (GPs) and undertakes local pension administration for GPs through Primary Care Support England (PCSE). NHS England has a monthly governance board in place to monitor and assure the delivery of the PCSE service, which includes an assessment of quality and performance indicators.

What assessment he has made of the adequacy of (a) PCSE and (b) Capita's management of the NHS pension scheme.

Primary Care Support England’s (PCSE) services are contracted to Capita Business Services Ltd under a contract held by NHS England. As part of the service, PCSE collects general practitioner pension contribution and earnings information and passes this to NHS Pensions, which is administered by the NHS Business Services Authority. NHS England has governance in place to oversee the performance of Capita Business Services Ltd in delivering the PCSE contract in a range of ways. This includes holding PCSE to account for service delivery using key performance indicators, monitoring of complaints, and annual third-party audits.

What assessment she has made of the adequacy of the internet-based platform used for the NHS Pension Scheme; and what steps she is taking to improve training for service handlers in using the platform.

Primary Care Support England (PCSE) launched the PCSE Online GP Pensions system to provide general practitioners and general practices with greater convenience, and more transparency and security when it comes to their pension contributions data. NHS England regularly monitors the effectiveness of PCSE Online, to ensure it continues to meet the needs of general practices. This includes performance management of the IT system and service, supporting PCSE’s webinar development and delivery for users, and working closely with NHS Pensions and the British Medical Association to ensure that training is reflective of any changes.

What recent assessment he has made of the adequacy of (a) Primary Care Support England's (b) Capita's management of the NHS Pensions Scheme.

The NHS Business Services Authority is the scheme manager for NHS Pensions. NHS England is the employing authority for general practices (GPs) and undertakes local pension administration for GPs through Primary Care Support England (PCSE). NHS England entered into a contract with Capita Business Services Ltd, also known as Capita, to deliver primary care support services and save costs. In order to monitor PCSE, NHS England has a monthly governance board in place to monitor and assure the delivery of the PCSE service, which includes assessment of quality and performance indicators.