Written questions by Gordon.

What assessment his Department has made of the potential merits of a national screening programme for Type 1 Diabetes.

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 supports implementation.A proposal for screening for neonatal diabetes mellitus was submitted to the UK NSC via its 2021 annual call process. An evidence-mapping exercise was conducted at that time which concluded that there was not sufficient evidence to recommend screening for this condition.We are aware that the UK NSC received a submission via its 2024 annual call process to consider screening for autoimmune Type 1 Diabetes through blood testing. The UK NSC is currently reviewing all annual call proposals. More information on the annual call process is available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal

Whether his Department has made an assessment of the the potential merits of implementing routine screening for Type 1 Diabetes to reduce the incidence of diabetic ketoacidosis at diagnosis.

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 supports implementation.A proposal for screening for neonatal diabetes mellitus was submitted to the UK NSC via its 2021 annual call process. An evidence-mapping exercise was conducted at that time which concluded that there was not sufficient evidence to recommend screening for this condition.We are aware that the UK NSC received a submission via its 2024 annual call process to consider screening for autoimmune Type 1 Diabetes through blood testing. The UK NSC is currently reviewing all annual call proposals. More information on the annual call process is available at the following link:https://www.gov.uk/government/publications/uk-nsc-annual-call-submitting-a-screening-proposal/uk-nsc-annual-call-how-to-submit-a-proposal

Whether he has made an assessment of the potential impact of the expiry of funding for T1DE pilot services on the health and well-being of patients in (a) Bournemouth and (b) London.

The National Health Service recognises the impact that type 1 diabetes with disordered eating can have on people and their families, which is why it has been piloting services to support those with the condition, and integrating care to help people improve their confidence and ability to manage their diabetes alongside their mental wellbeing. These pilots have shown improved outcomes for patients and cost effectiveness, and the NHS has now expanded sites to every region of the country, so that even more people can benefit from them.The Department, in partnership with NHS England and the Royal College of Psychiatrists, produced the Medical Emergencies in Eating Disorders guidance in May 2022, which has a full annexe on type 1 diabetes and eating disorders, and they are currently working to roll out the guidance to all systems.NHS England is continuing to expand community-based eating disorder service capacity, including crisis care and intensive home treatment, to improve outcomes and recovery, reduce rates of relapse, prevent eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce lengths of stay. NHS England has asked local health systems, through this year’s NHS operational planning guidance, to focus on improving performance against the waiting time standards for children’s eating disorders services of 95% of urgent cases seen within one week, and 95% of routine cases seen within four weeks.

What steps his Department is taking to ensure individuals with type one diabetes and disordered eating have access to integrated care for both their (a) physical and (b) mental health needs.

The National Health Service recognises the impact that type 1 diabetes with disordered eating can have on people and their families, which is why it has been piloting services to support those with the condition, and integrating care to help people improve their confidence and ability to manage their diabetes alongside their mental wellbeing. These pilots have shown improved outcomes for patients and cost effectiveness, and the NHS has now expanded sites to every region of the country, so that even more people can benefit from them.The Department, in partnership with NHS England and the Royal College of Psychiatrists, produced the Medical Emergencies in Eating Disorders guidance in May 2022, which has a full annexe on type 1 diabetes and eating disorders, and they are currently working to roll out the guidance to all systems.NHS England is continuing to expand community-based eating disorder service capacity, including crisis care and intensive home treatment, to improve outcomes and recovery, reduce rates of relapse, prevent eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce lengths of stay. NHS England has asked local health systems, through this year’s NHS operational planning guidance, to focus on improving performance against the waiting time standards for children’s eating disorders services of 95% of urgent cases seen within one week, and 95% of routine cases seen within four weeks.

What steps his Department is taking to help develop guidelines for (a) general practitioners and (b) diabetes care teams on managing type one diabetes and disordered eating.

The National Health Service recognises the impact that type 1 diabetes with disordered eating can have on people and their families, which is why it has been piloting services to support those with the condition, and integrating care to help people improve their confidence and ability to manage their diabetes alongside their mental wellbeing. These pilots have shown improved outcomes for patients and cost effectiveness, and the NHS has now expanded sites to every region of the country, so that even more people can benefit from them.The Department, in partnership with NHS England and the Royal College of Psychiatrists, produced the Medical Emergencies in Eating Disorders guidance in May 2022, which has a full annexe on type 1 diabetes and eating disorders, and they are currently working to roll out the guidance to all systems.NHS England is continuing to expand community-based eating disorder service capacity, including crisis care and intensive home treatment, to improve outcomes and recovery, reduce rates of relapse, prevent eating disorders continuing into adulthood and, if admission is required as a very last resort, reduce lengths of stay. NHS England has asked local health systems, through this year’s NHS operational planning guidance, to focus on improving performance against the waiting time standards for children’s eating disorders services of 95% of urgent cases seen within one week, and 95% of routine cases seen within four weeks.

What estimate he has made of GP-to-patient ratios in (a) Harrogate and Knaresborough constituency and (b) North Yorkshire in each of the last five years.

Each general practice (GP) is required to provide services to meet the reasonable needs of their patients. There is no recommendation from NHS England for how many patients a GP should have assigned, or the ratio of GPs or other practice staff to patients. The demands each patient places on their GP are different and can be affected by many different factors, including rurality and patient demographics. It is necessary to consider the workforce for each practice as a whole, not only the GPs but also including the range of health professionals available who are able to respond to the needs of their patients. The following table shows the full-time equivalent (FTE) doctor to patient ratios in the Harrogate and Knaresborough constituency, for the last five years:DateMedian number of GP FTE doctors per 10,000 registered patientsSeptember 20206.9September 20216.3September 20226.8September 20236.4September 20246.7 While it is not possible to provide data specifically for the county of North Yorkshire, the following table shows the FTE GP doctor to patient ratios within the Humber and North Yorkshire Integrated Care Board (ICB), for the last five years: DateMedian number of GP FTE doctors per 10,000 registered patientsSeptember 20205.8September 20215.6September 20225.7September 20235.8September 20246.2Notes: the data does not include estimates for practices that did not provide fully valid staff records;doctors in GP includes both fully qualified GPs and GPs in training grades;FTE refers to the proportion of full-time contracted hours that the post holder is contracted to work, as one would indicate they work a full set of hours, 37.5 hours, and 0.5 would indicate that they worked half time;in the GPs in Training Grade contracts, one FTE equals 40 hours, and in this table these FTEs have been converted to the standard Workforce Minimum Data Set measure, of one FTE equalling 37.5 hours, for consistency;figures shown do not include staff working in Prisons, Army Bases, Educational Establishments, Specialist Care Centres, including Drug Rehabilitation Centres, Walk-In Centres and other alternative settings outside of traditional GPs, such as urgent treatment centres and minor injury units;practices in the Harrogate and Knaresborough constituency were identified using practice postcodes and the National Statistics Postcode Lookup; andat both an ICB and constituency level, practices have been assigned to these geographies using their 2024 boundaries.

What steps his Department is taking to help increase the early diagnosis rate for bowel cancer.

The Department is taking steps to improve the rate of early diagnosis for all cancers, including bowel and bowel-related cancers. We will support the National Health Service to transform diagnostic services by spending £1.5 billion on new surgical hubs and diagnostic scanners, to build capacity for over 30,000 more procedures and 1.25 million diagnostic tests.

What steps his Department is taking to help improve outcomes for bowel cancer.

The National Health Service is taking crucial steps to improve cancer outcomes for patients across England, including for bowel cancer. We will improve cancer survival rates and hit all NHS cancer waiting time targets, so no patient waits longer than they should.The NHS will maximise the pace of roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing community diagnostic centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.The NHS Bowel Cancer Screening program currently invites people aged between 56 and 74 years old for screening every two years. However, this age cohort is increasing to people aged between 50 and 74 years old by 2025 with the use of Faecal Immunochemical Test kits which can be sent directly to people's homes.

What steps his Department plans to take to reduce the number of people waiting more than 6 weeks for a colonoscopy in England.

Cutting waiting lists is a key priority for the Government. It is unacceptable that some patients are waiting over six weeks for a diagnostic test, including for a colonoscopy. To cut waiting lists for diagnostic tests, each integrated care board will have a recovery plan for diagnostic services, including endoscopy as needed.NHS England is continuing to develop gastrointestinal (GI) endoscopy networks across the country, which will address variations in care, including in the timely access to care. The Department is supporting NHS England in completing the rollout and expansion of the community diagnostic programme, including delivering additional endoscopy capacity closer to patients in the community. GI endoscopy training academies have also been established, with one per region, to enable the training and education of the required workforce.The National Health Service is delivering on a number of specific steps to reduce waiting times for GI endoscopy services, including colonoscopy procedures. This includes the establishment of a national transformation project to enable and support the timely recovery of GI endoscopy services, and investment into an expected net increase of 80 additional dedicated endoscopy rooms to expand capacity, as well as a number of Community Diagnostic Centres offering endoscopy services.

What steps he is taking to reduce waiting times for the (a) diagnosis and (b) treatment of bowel cancer.

Lord Darzi’s report has set out the scale of the challenges we face in fixing the National Health Service, and the need to improve cancer waiting time performance and cancer survival. In particular, he has highlighted the need to improve the number of patients starting their treatment within 62 days of referral, and increase the number of patients diagnosed at an earlier stage.The NHS will maximise the pace of the roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs) and ensuring timely implementation of the new CDC locations, and upgrades to existing CDCs, with capacity prioritised for cancer diagnostics.We are committed to transforming diagnostic services, and will support the NHS to increase capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners. Furthermore, in 2024/25, we will continue to extend the NHS Bowel Cancer Screening Programme to additional cohorts, specifically to 50 to 52-year olds.

What steps his Department is taking to tackle the (a) physical and (b) mental health challenges faced by unpaid carers.

The Government is committed to ensuring that families have the support that they need. We want to ensure that people who care for family and friends are better able to look after their own physical and mental health and wellbeing.People, including unpaid carers, with mental health issues are not getting the support or care they deserve, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health. This includes recruiting 8,500 more mental health workers, introducing specialist mental health professionals in every school, rolling out Young Futures hubs in every community, and modernising the Mental Health Act.

How many and what proportion of eligible people have received a check through the targeted lung health check programme in Yorkshire since the establishment of that programme; and what steps he plans to take to help increase the update of those checks.

The NHS Lung Cancer Screening Programme is available in some areas of England and offers a lung cancer screen to those who are over 55 years old but younger than 75 years old; are registered with a general practitioner; and have a history of smoking.The Yorkshire region is covered by three Cancer Alliances. NHS England has advised that in the Humber and North Yorkshire, of the 202,527 estimated eligible population, 75,973 people were invited for a lung check, representing 37.5% population coverage. 34,217 had lung checks, and 24,726 had scans. Uptake since inception of the programme is 45%.In West Yorkshire and Harrogate, of the 202,836 estimated eligible population, 36,277 were invited, representing 17.9% population coverage. 19,941 people had lung checks, and 10,404 had scans. Uptake since inception of the programme is 55%.In South Yorkshire and Bassetlaw, of the 177,788 estimated eligible population, 132,658 were invited, representing 74.6% population coverage. 49,682 had lung checks, and 32,561 had scans. Uptake since inception of the programme stands at 37%.The Cancer Alliances undertake a range of community engagement, advertising, and ‘reminder’ activities to increase uptake. At a national level, NHS England continues to carry out behavioural insights research to inform their approach to supporting and improving uptake of the programme. NHS England has produced a range of engagement assets including for social media adverts, leaflets and posters which are used by local sites. They aim to run further social media adverts in future.The NHS Lung Cancer Screening programme will be fully rolled out by 2029.

What steps he plans to take to (a) increase breast cancer screening rates to pre-covid-19 levels and (b) meet his Department's breast cancer screening targets.

Following COVID-19, a national restoration plan was implemented by NHS England in 2020/21 with targeted support to all breast screening services, to clear the backlog by the summer of 2023. In 2021/22 and 2022/23, activity was higher than in the previous 10 years with more women invited for breast screening compared to pre-pandemic years.NHS England’s national uptake improvement plan aims to address the fact that despite this action, some women are still not coming forward for breast screening. The plan includes active follow up of women who have missed appointments or who have not engaged with screening, a review to establish reasons for non-attendance to identify and address any barriers, and a look at how different invitation methods may impact on uptake, for instance factors such as age, screening history, and deprivation.

How many complaints relating to the mental healthcare service at Tees, Esk and Wear Valleys NHS trust there have been in each of the last three years.

The following table shows information on concerns received by Tees, Esk and Wear Valleys NHS Foundation Trust between 2021/22 and 2023/24: Reporting yearLocal issue resolutionConcerns raised with Patient Advice and Liaison ServiceComplaintsTotal2023/242061,7734982,4472022/23n/a2,4463382,7842021/22n/a2,2812932,574Source: Tees, Esk and Wear Valleys NHS Foundation Trust Quality Accounts Note: Concerns can range from an issue with a person’s care to environmental factors, such as parking on the Trust’s sites. The Trust has advised that all complaints are managed in line with national guidance and it is committed to providing opportunities for its patients, their carers or their families to seek advice or information, raise concerns or make a complaint about the services that the Trust provides.

How many avoidable or preventable deaths of mental health patients at Tees, Esk and Wear Valleys NHS trust there have been in each of the last three years.

Information on the number of deaths reported to Tees, Esk and Wear Valleys NHS Foundation Trust's incident reporting system are shown in the table. These are not categorised as preventable or avoidable.Reporting yearTotal2021/222,1632022/232,3292023/241,322Source: Tees, Esk and Wear Valleys NHS Foundation Trust Quality AccountsIt is important to note that the majority of deaths of people in the Trust’s care from natural causes and therefore include end of life care and longstanding poor physical health. There is further detail and context within the Trust’s Quality Account for each year.

What assessment he has made of the potential impact of the time taken to access radiotherapy treatment on cancer outcomes; and what steps his Department is taking to ensure patients that need radiotherapy treatment can access it as quickly as possible.

The Government believes that cancer patients are waiting too long for diagnosis and treatment, including radiotherapy treatment. We will get the National Health Service diagnosing cancer earlier and treating it faster. We will improve patients’ experience across the system.Lord Darzi’s report has set out the scale of the challenges we face in fixing the NHS and the need to improve cancer waiting time performance and cancer survival. In particular, he has highlighted the need to improve the number of patients starting their treatment within 62 days of referral and to increase the number of patients diagnosed at an earlier stage.Improving 62-day performance and early diagnosis are already key priorities for NHS England. Lord Darzi’s report will inform our ten-year plan to reform the NHS, which include further details on how we will improve cancer diagnosis, treatment, and outcomes.

What proportion of eligible people in Yorkshire and the Humber have been screened through the national targeted lung cancer screening programme since July 2023; and what steps he is taking to increase the level of uptake for that scheme.

The NHS Lung Cancer Screening Programme is available in some areas of England and offers a lung cancer screen to those who are over 55 years old but younger than 75 years old; are registered with a general practitioner; and have a history of smoking.NHS England has advised that to the end of August 2024, 36.3% of the eligible population in the Humber and North Yorkshire Cancer Alliance has been invited to the Lung Cancer Screening programme since 2019, with 16,103 people participating between July 2023 and July 2024. Estimated uptake for May to July 2024, the most recent available three months of data, was 55.4%. This has improved significantly with the rolling average for the last 12 months being 47.8%.A wide range of initiatives continues to be carried out to improve uptake in the NHS Lung Cancer Screening Programme. For example, at a national level this includes using social media, leaflets and posters to promote the programme and at a local level, using text messaging to remind people of their appointment. Cancer Alliances are also bringing together primary care networks, lung cancer screening teams and communication colleagues to ensure collaborative and informed working is taking place.The NHS Lung Cancer Screening Programme will be fully rolled out to 100% of the eligible population by 2029.

If he will take steps to ensure that NHS providers prioritise funding for (a) upgrades and (b) replacements of radiotherapy machines.

The Government will continue to support the provision of radiotherapy machines, however since April 2022 the responsibility for investing in new radiotherapy machines has been with local systems.

If he will publish mortality rates of mental health patients at Tees, Esk and Wear Valleys NHS Foundation Trust.

Tees, Esk and Wear Valleys NHS Foundation Trust publishes the information requested (under ‘Learning from deaths’) as part of its annual Quality Account report about the quality of the services provided by the Trust. The most recent report is available at the following link:www.tewv.nhs.uk/wp-content/uploads/2024/07/Quality-Account-23-24-Final.pdf

Whether he has made an assessment of the potential merits of developing a specific action plan for (a) cancers of the (i) brain, (ii) liver, (iii) lung, (iv) stomach, (v) oesophagus and (vi) pancreas and (b) other less survivable cancers.

The Government has not made an assessment of the potential merits of an action plan for less survivable cancers individually or as a group, or had specific discussions with international counterparts on their approach to less survivable cancers.Lord Darzi’s report has set out the scale of the challenges we face in fixing the National Health Service, and the need to improve cancer waiting time performance and cancer survival. The report will inform the Government’s ten-year plan to reform the NHS, including further detail on how we will improve outcomes for cancer, including less survivable cancers.