Written questions by Collins.

Whether his Department plans to hold discussions with suppliers of medical equipment to community care services on social care reform.

On 30 January 2025, NHS England published guidance on Standardising community health services, specifically codifying core services, which can be found at the following link:https://www.england.nhs.uk/long-read/standardising-community-health-services/Community health services cover a diverse range of healthcare delivery, and the guidance supports improved commissioning and delivery of community healthcare services. Codifying community health services will help to better assess demand and capacity and will help commissioners make investment choices as they design neighbourhood health provision that shifts care to community-based settings.This publication is available for designing, commissioning, and delivering community health services, including neighbourhood health. Integrated care boards and their partners should consider the core components to support demand and capacity assessment and planning with providers, and should ensure the best use of funding to meet local needs and priorities.Many National Health Service trusts and local authorities offer an Integrated Community Equipment Service (ICES) within the integrated health and social care system, as they support both the home first agenda and hospital flows. These services can be provided in-house or by external suppliers following a tender exercise. An ICES enables people to remain in or return to their homes as the primary setting for care, avoiding unnecessary stays in hospital or care homes. Also, an ICES facilitates timely hospital admissions, treatment, and discharge processes, minimising delays and improving capacity across the sector.

What assessment he has made of the potential merits of introducing mandatory nutritional targets for large supermarket retailers.

The Government is committed to raising the healthiest generation of children ever and tackling the three biggest killers, which will require effort from across society, not just for obesity but also for alcohol and smoking.We have made a start with the Tobacco and Vapes Bill and will continue to speak to partners across industry and civic society to best understand what actions help to change behaviours in a way that puts power in the hands of consumers.As part of the Government’s Plan for Change, we are committed to achieving our Health Mission to build a National Health Service fit for the future, and under the 10-Year Health Plan, to shift from sickness to prevention. Making the healthier choice the easier choice is a major part of creating a food environment that is fairer, with the fewest lives lost to the biggest killers, and where everyone lives well for longer.As part of considerations around mandatory healthiness targets, the previous administration brought together the Food Data Transparency Partnership (FDTP), a shared programme of work across the Department of Health and Social Care, the Department for Environment, Food, and Rural Affairs, and the Food Standards Agency. Separate from the eco strand of FDTP headed by the Department for Environment, Food, and Rural Affairs, the FDTP health strand was paused at the election and is being reviewed alongside other obesity policies.

What steps his Department is taking to reduce differences in healthy life expectancy between regions in England.

Tackling health inequalities is central to our Health Mission, which is why the Government has committed to halving the healthy life expectancy gap between the richest and poorest regions, by addressing the social determinants of health. Work is currently underway across the Department and with NHS England and the regional Directors of Public Health to develop approaches to address regional health inequalities.In line with the Health Mission, we will also be launching a 10-Year Health Plan with the core focus of addressing healthcare inequity, ensuring the National Health Service is there for anyone who needs it, whenever they need it.

What assessment he has made of the potential impact of introducing regulations on the advertising of products high in fat, sugar or salt (a) in outdoor spaces and (b) on audio-only media on public health.

The Government is taking bold action to tackle the childhood obesity crisis, and will create the healthiest generation of children ever. We are progressing with the implementation of the advertising restrictions for less healthy food or drink products on television and online. This includes a 9:00pm watershed on television and a 24-hour restriction on paid-for advertising of these products online. These restrictions are expected to remove up to 7.2 billion calories from children’s diets per year and reduce the number of children living with obesity by 20,000.An assessment has not been made on the potential impact of introducing regulations on the advertising of products high in fat, sugar, or salt in outdoor spaces or on audio-only media on public health. Audio-only media, for instance podcasts or online radio, are exempt from the advertising restrictions due to limited evidence about the child audience for these services and the effect they have on children’s food consumption.We continue to review evidence of the impacts on children of advertising for less healthy food and drink products and will consider where further action is needed.

What steps his Department is taking to improve support for family carers in Harpenden and Berkhamsted constituency.

The Government is committed to ensuring that families have the support they need. Local authorities have duties to support people caring for their family and friends. The Care Act 2014 requires them to provide a wide range of sustainable, high-quality care and support services, including support for carers.On the 7 of April 2025, the Government increased the Carer’s Allowance weekly earnings limit from £151 a week to £196, the equivalent of 16 hours at the National Living Wage. This represents the largest increase in the earnings limit since the Carer’s Allowance was introduced in 1976.Lord Darzi’s independent review of the National Health Service highlighted the need for a fresh approach to supporting and involving unpaid carers, to improve outcomes across the board, for carers, for those they care for, and the NHS itself.These findings will be carefully considered as part of our 10-year plan to reform and modernise the NHS, and as we continue to shape our plans to reform adult social care, including through the National Care Service.We have launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service.The commission will start a national conversation about what care and support working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support.

What recent assessment his Department has made of the adequacy of access to emergency dentistry in Harpenden and Berkhamsted constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Harpenden and Berkhamsted constituency this is the Hertfordshire and West Essex ICB. ICBs have been asked to start making extra urgent dental appointments available from April 2025. The Hertfordshire and West Essex ICB are expected to deliver 5,712 additional urgent dental appointments as part of the scheme.

What steps his Department is taking to increase the rate of discharge from hospitals into social care in (a) Harpenden and Berkhamsted constituency and (b) England.

It is a priority for the Government to support hospital discharge and ensure that people receive the care that they need.On 30 January 2025, the Government published the policy framework for the Better Care Fund (BCF) in 2025/26, which took effect on 1 April 2025. The new BCF Policy Framework supports local areas to use pooled funding in a way that reduces delayed discharges and delivers greater impact for those receiving integrated care.£9 billion of funding is available through the BCF for 2025/26, including £149 million provided to Hertfordshire. This consists of £110 million to the Hertfordshire and West Essex and Cambridgeshire and Peterborough Integrated Care Boards, and £39 million to Hertfordshire County Council.

What steps his Department is taking to help reduce barriers to social care for (a) deafblind people and (b) other disabled people with complex needs in (i) Harpenden and Berkhamsted constituency and (ii) the rest of England.

Under the Care Act 2014 and Care and Support (Assessment) Regulations 2014, local authorities are responsible for ensuring people with complex disabilities, including deafblind people, access the right care and support. Under the Equality Act (2010), local authorities must also make reasonable adjustments to ensure that disabled people are not disadvantaged.The Care Quality Commission (CQC) is assessing how well local authorities in England are performing against their duties under Part 1 of the Care Act 2014, including their duties relating to the access and provision of care and support for people with complex disabilities. Support for people with complex disabilities will form part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will, for example, report on how the local authorities work with deafblind people when there is something important to highlight, such as something being done well, innovative practice, or an area for improvement. The CQC is assessing all 153 local authorities in England. So far, the CQC has published over twenty assessments, including an assessment for Hertfordshire County Council, which is available at the following link:https://www.cqc.org.uk/care-services/local-authority-assessment-reports/Hertfordshire1By identifying local authorities’ strengths and areas for improvement, CQC assessments facilitate the sharing of good practice and help us to target support where it is most needed. These steps will help to ensure that people with complex disabilities, including deafblind people, do not face barriers to accessing appropriate care.

What steps his Department is taking to ensure that deafblind people can access appropriate social care in (a) Harpenden and Berkhamsted constituency and (b) the rest of England.

Under the Care Act 2014 and Care and Support (Assessment) Regulations 2014, local authorities are responsible for ensuring people with complex disabilities, including deafblind people, access the right care and support. Under the Equality Act (2010), local authorities must also make reasonable adjustments to ensure that disabled people are not disadvantaged.The Care Quality Commission (CQC) is assessing how well local authorities in England are performing against their duties under Part 1 of the Care Act 2014, including their duties relating to the access and provision of care and support for people with complex disabilities. Support for people with complex disabilities will form part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will, for example, report on how the local authorities work with deafblind people when there is something important to highlight, such as something being done well, innovative practice, or an area for improvement. The CQC is assessing all 153 local authorities in England. So far, the CQC has published over twenty assessments, including an assessment for Hertfordshire County Council, which is available at the following link:https://www.cqc.org.uk/care-services/local-authority-assessment-reports/Hertfordshire1By identifying local authorities’ strengths and areas for improvement, CQC assessments facilitate the sharing of good practice and help us to target support where it is most needed. These steps will help to ensure that people with complex disabilities, including deafblind people, do not face barriers to accessing appropriate care.

What plans he has to include people impacted by low-grade brain tumours which follow the cancer pathways, care and treatment, but are not technically cancer in the National Cancer Plan.

The National Cancer Plan will include further details on how we will improve outcomes for all cancer patients, including those with brain tumours.Although low-grade brain tumours are generally non-cancerous, they can have similar, serious symptoms and require surgery or radiotherapy to treat. The Government has invested in new lifesaving and life-improving research, supporting those diagnosed and living with brain tumours.The plan will include further details on how we will speed up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately bringing this country’s cancer survival rates back up to the standards of the best in the world.

Whether the Pfizer COVID-19 vaccine will be offered by the NHS in the Spring booster programme.

The spring 2025 campaign will continue to use mRNA vaccine supply secured under existing pandemic contracts with Pfizer and Moderna. Those eligible will be offered either Moderna or Pfizer/BioNTech vaccines during the spring 2025 campaign.

Whether he plans to increase the role of hospices in providing care in communities.

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 palliative and end of life care services, including hospices, will have a big role to play in that shift.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.

Whether his Department plans to include lung health in the NHS 10-Year Health Plan.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving respiratory health in all parts of the county. More tests and scans delivered in the community will allow earlier diagnosis, better joint working between services, and greater use of apps and wearable technology will all help people manage their long-term conditions, including respiratory conditions, closer to home. Earlier diagnosis of conditions will help prevent deterioration and improve survival rates. Taking action to reduce the causes of the biggest killers, such as enabling a smoke free generation, can further help prevent lung conditions.

Whether his Department will take steps to prioritise the reform of funding for (a) palliative and (b) end-of-life care in the NHS 10-year plan.

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 families receive the care they need when and where they need it, including those who need palliative and end of life care. As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners, including the hospice sector.

What plans his Department have to extend the Start for Life programme beyond the 75 upper-tier local authorities that currently receive funding.

In 2025/26, £57 million will be made available to 75 local authorities with high levels of deprivation to provide a range of Start for Life services. Funding for future years is being considered as part of the forthcoming Spending Review.

If he will make an assessment of the adequacy of (a) commissioning funding of integrated care boards and (b) other funding provided to hospice services.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for commissioning palliative and end of life care services to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance which outlines areas for consideration when commissioning.Additionally, although not statutory, the National Institute for Health and Care Excellence has published guidance on the service delivery of end of life care. There is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health 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.NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.We are, at a national level, also 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. An additional £75 million will be allocated in the coming weeks for use in 2025/26.Additionally, we are providing £26 million of revenue funding to support children and young people’s hospices for 2025/26. This is a continuation of the funding which until recently was known as the children and young people’s hospice grant. NHS England has now communicated the details of the 2025/26 funding allocation and dissemination to individual hospices.In February, I met with key palliative and end of life care and hospice stakeholders, with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.

What steps his Department is taking to help prevent (a) staff shortages in and (b) the closure of local pharmacies.

The Government recognises that pharmacies play a vital role in our healthcare system. We are committed to expanding the role of pharmacies and better utilising the skills of pharmacists and pharmacy technicians. Employers clearly have a key role in retaining staff and making jobs in community pharmacy attractive. To support employers, NHS England has provided a number of fully funded national training opportunities for pharmacists and pharmacy technicians to help support private contractors to deliver quality National Health Services, including Pharmacy First.We have now concluded the consultation on funding for 2024/25 and 2025/26, and have agreed with Community Pharmacy England to increase the community pharmacy contractual framework to £3.073 billion. This deal represents the largest uplift in funding of any part of the NHS, over 19% across 2024/25 and 2025/26. This shows a commitment to rebuilding the sector.

What steps his Department is taking to provide additional support for families affected by members with Duchenne muscular dystrophy.

The Government is committed to improving the lives of those living with rare diseases, such as Duchenne Muscular Dystrophy. Under the England Rare Diseases Action Plan 2025, we remain focused on delivering against the four key priorities set out in the UK Rare Diseases Framework. The 2025 England Rare Diseases Action Plan was published on 28 February 2025 and is available at the following link:https://www.gov.uk/government/publications/england-rare-diseases-action-plan-2025We know that people living with rare conditions, and their families and carers, often struggle to access mental health and psychological support. Mental health services should be offered based on need and should not exclude anyone because of a particular physical health or neurological diagnosis. The NHS Genomics Education Programme has this year published new resources on rare diseases and mental health, aimed at healthcare professionals. It has also developed a communications tool to help healthcare professionals with sensitive conversations, to ensure that patients and families feel supported throughout the diagnosis of a rare condition.Many people struggle to access reliable information on rare diseases, and we recognise the important role patient support groups can play in developing reliable and easy to access information. In this year’s action plan we have set out the steps we are taking to support organisations to get the information they produce accredited under the Patient Information Forum’s trusted information creator scheme.To enhance specialist care, NHS England is supporting multi-system disorder clinics to reduce appointments and ease care coordination for families.

What steps his Department is taking to help tackle shortages of medication for (a) Parkinson's and (b) epilepsy.

The Department is working hard with industry to help resolve intermittent supply issues with some epilepsy medications. As a result of ongoing activity and intensive work, including directing suppliers to expedite deliveries, most issues, including with carbamazepine, lamotrigine, and oxcarbazepine presentations, have been resolved.We are currently aware of an ongoing supply issue with all strengths of topiramate tablets from one manufacturer. This supply issue is expected to resolve by the end of May 2025. We are also aware of a shortage of phenobarbital 15 milligram tablets from one manufacturer with the resupply date to be confirmed. In both cases, alternative suppliers are in stock with sufficient supply to support patients. These issues have been communicated to the National Health Service.The Department is aware of supply constraints with one supplier of amantadine 100 milligram capsules used in the management of Parkinson’s disease, however stocks remain available from alternative suppliers to cover demand. The Department has also been notified of a discontinuation of apomorphine (APO-go PFS) 50 milligram/10 millilitre pre-filled syringes from April 2025. Alternative formulations of apomorphine remain available for patients, and management guidance has been issued to the NHS.

What steps his Department is taking to improve early diagnosis of endometriosis.

The Government is committed to prioritising women’s health, and we are making progress to ensure that women with endometriosis receive a timely diagnosis and effective treatment.Clinical guidelines support healthcare professionals to diagnose and treat conditions. In November 2024, the National Institute for Health and Care Excellence updated its guideline on the diagnosis and management of endometriosis. This includes updated recommendations that for women with symptoms of endometriosis, initial pharmacological treatment should take place in primary care, and that this can take place in parallel with additional investigations and referral to secondary care if needed. This will help women receive more timely treatment. The guideline is available at the following link:https://www.nice.org.uk/guidance/ng73We have taken urgent action to tackle gynaecology waiting lists through the Elective Reform Plan. In gynaecology, the plan supports innovative models offering patients care closer to home, and piloting gynaecology pathways in community diagnostic centres. Alongside the plan we published a new partnership agreement between the National Health Service and the independent sector, which will help cut gynaecology waiting lists faster.Additionally, to provide quicker access for patients to common surgical hub procedures such as a laparoscopy, which can be used to diagnose and treat endometriosis, we have committed to opening 17 new and expanded surgical hubs by June 2025 and ramping up the number of hubs over the next three years.