Written questions by Franklin.

What steps his Department is taking to reduce the gap in healthy life expectancy between the country’s most and least deprived communities.

The Government’s 10-Year Health Plan sets out our ambitious commitment to halve the healthy life expectancy gap between the richest and poorest regions. We know that reducing the gap will require action on challenges that are more prevalent in areas with lower healthy life expectancy. This is why, for example, we are taking action to tackle the obesity crisis and delivered the world-leading Tobacco and Vapes Act to support our ambition for a future smoke-free United Kingdom. Reducing this gap is not just a health challenge, which is why we are also taking a range of cross-Government action to tackle health inequality. This includes the introduction of Awaab’s Law, ensuring landlords will have to fix significant damp and mould hazards, and legislating for a new statutory health and health inequalities duty for strategic authorities.

If he will set out the contractual requirements that apply to independent sector providers delivering NHS-funded cataract surgery, including whether they are required to accept an appropriate case mix rather than lower-complexity patients.

Independent sector providers are commissioned and managed by integrated care boards (ICBs) under the terms of the NHS Standard Contract which applies the same standards of oversight and regulation as are applied to National Health Service providers.In the 10-Year Health Plan for England, we set out we would not tolerate ‘gaming’ the national payment tariff to cherry pick the simplest, most profitable cases. ICBs are expected to monitor this, and act decisively where they identify problems as part of a wider duty to safeguard and ensure value for taxpayer money.

What steps he is taking to support community pharmacies to improve accessibility for people who are deaf, hard of hearing, or living with dual sensory loss; and whether he is taking steps to support the provision of reasonable adjustments, including hearing loops, to ensure patients can safely access advice and treatment.

The Department recognises the importance of ensuring community pharmacy services are safe and accessible to all patients, including those with sensory impairments. In addition to legal requirements under the Equality Act 2010 and the Human Rights Act 1998, pharmacy businesses have a duty to comply with the General Pharmaceutical Council’s (GPhC) standards for registered pharmacy premises. This requires pharmacies to provide an environment that is safe and accessible for all, taking reasonable steps to remove barriers for patients with disabilities. These standards emphasise the need for pharmacies to make adjustments to facilities and services, such as providing accessible entrances, hearing loops, and assistance for individuals with mobility or sensory challenges. To support community pharmacies in meeting their legal duties, the GPhC has issued equality guidance for pharmacies, which outlines best practices for supporting patients with a range of needs. NHS England is also rolling out a Reasonable Adjustment Digital Flag which enables the recording of key information about a disabled patient and the reasonable adjustments to care and treatment that they need, to ensure support can be tailored appropriately and equitably. This is being rolled out nationally across all healthcare settings and will help community pharmacies spot when a patient may need extra support.

What assessment he has made of regional variation in access to children’s hospice services; and what steps he is taking to ensure equitable provision across England.

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 children and young people’s hospices, also play in providing support to children at the end of life, as well as their loved ones.We recognise that there is variation in access to children and young people’s hospice services across England. This reflects a range of factors, including the way in which the independent hospice sector has historically developed, which was largely not planned with a view to ensure even geographical coverage or to prioritise areas of greatest need based on demographics. However, it is worth recognising that hospices are not the sole providers of palliative care and end of life care, much of which is provided by NHS statutory services.Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment.We supported the hospice sector in England with a £125 million capital funding boost for adult, and children and young people’s hospices to ensure they have the best physical environment for care. We are also providing approximately £80 million of revenue funding for children and young people’s hospices over three financial years, from 2026/27 to 2028/29, giving them the stability they need to plan ahead.For the long-term, the Government is developing a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care for England, with a planned publication date of Autumn 2026. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, and we will also consider contracting and commissioning arrangements as part of this work.

Whether his Department is taking steps to ensure that NHS commissioning ensures equivalent employment practices in outsourced NHS services.

The Government is committed to making work pay and ensuring that outsourced services are delivered in a way that improves quality, gives greater stability and longer-term investment in the workforce, and delivers better value for money as part of the broader commitments on procurement.In December 2025 the Employment Rights Act received Royal Assent and passed into law. This act aims to enhance worker security, fairness, and pay, as well as banning exploitative practices.

What assessment he has made of the potential impact of staff providing NHS services being employed on different contractual terms to NHS Agenda for Change staff on (a) equality and (b) the workforce.

This specific assessment has not been made. Independent organisations commissioned by the National Health Service in England, such as general practices or social enterprises, are free to develop and adapt their own terms and conditions of employment, including the pay scales that they use.Where such organisations choose to dynamically link to any of the national contracts, including Agenda for Change, those staff will be contractually entitled to receive the same uplifts in pay and associated terms and conditions as staff employed in NHS organisations.

If he will make an assessment of the potential implications for his policies of commissioning arrangements in NHS breast screening services that result in staff providing NHS services being employed on terms and conditions different from NHS Agenda for Change contracts.

Breast screening services that deliver the NHS Breast Screening Programme are mainly within National Health Service trusts, with staff on Agenda for Change terms or conditions or medical staff on the consultant, both medical and dental, pay scale. The exception to this is the very small number of breast screening services provided by private providers. Staff delivering breast screening are directly employed by the host organisation not by NHS England.With regards the plans to transfer NHS England’s direct commissioning function to integrated care boards from April 2027, staff will remain on NHS terms and conditions.

If his Department will take steps to ensure that agency care workers receive appropriate and accredited training to meet the needs of vulnerable service users.

We have understood that the term care agencies refers to employment agencies. Care providers are required to be registered with the Care Quality Commission (CQC) where they carry out a regulated activity, as described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, employment agencies do not usually carry out regulated activity and as such do not typically need to be registered.Providers such as care homes and those providing domiciliary care do typically carry out regulated activity and therefore are registered with the CQC. The CQC requires all health and social care providers registered with them to deploy enough suitably qualified, competent, and experienced staff, including both registered and unregistered professionals. This requirement applies where that provider chooses to recruit staff via employment agencies.It is therefore the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role.To support providers to do so, the Department provides reimbursement towards the cost of training and qualifications through the Adult Social Care Learning and Support Scheme, backed by up to £12 million in funding this financial year.

Whether his Department has made an assessment of the adequacy of care provided by care agencies to vulnerable people.

We have understood that the term care agencies refers to employment agencies. Care providers are required to be registered with the Care Quality Commission (CQC) where they carry out a regulated activity, as described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, employment agencies do not usually carry out regulated activity and as such do not typically need to be registered.Providers such as care homes and those providing domiciliary care do typically carry out regulated activity and therefore are registered with the CQC. The CQC requires all health and social care providers registered with them to deploy enough suitably qualified, competent, and experienced staff, including both registered and unregistered professionals. This requirement applies where that provider chooses to recruit staff via employment agencies.It is therefore the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role.To support providers to do so, the Department provides reimbursement towards the cost of training and qualifications through the Adult Social Care Learning and Support Scheme, backed by up to £12 million in funding this financial year.

What steps his Department is taking to prevent care agencies from supplying staff who deliver unsupervised personal care without the required registration with the Care Quality Commission.

We have understood that the term care agencies refers to employment agencies. Care providers are required to be registered with the Care Quality Commission (CQC) where they carry out a regulated activity, as described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, employment agencies do not usually carry out regulated activity and as such do not typically need to be registered.Providers such as care homes and those providing domiciliary care do typically carry out regulated activity and therefore are registered with the CQC. The CQC requires all health and social care providers registered with them to deploy enough suitably qualified, competent, and experienced staff, including both registered and unregistered professionals. This requirement applies where that provider chooses to recruit staff via employment agencies.It is therefore the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role.To support providers to do so, the Department provides reimbursement towards the cost of training and qualifications through the Adult Social Care Learning and Support Scheme, backed by up to £12 million in funding this financial year.

What steps his Department is taking to improve oversight of care agencies and to enhance enforcement powers against providers who fail to meet required care standards.

We have understood that the term care agencies refers to employment agencies. Care providers are required to be registered with the Care Quality Commission (CQC) where they carry out a regulated activity, as described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, employment agencies do not usually carry out regulated activity and as such do not typically need to be registered.Providers such as care homes and those providing domiciliary care do typically carry out regulated activity and therefore are registered with the CQC. The CQC requires all health and social care providers registered with them to deploy enough suitably qualified, competent, and experienced staff, including both registered and unregistered professionals. This requirement applies where that provider chooses to recruit staff via employment agencies.It is therefore the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role.To support providers to do so, the Department provides reimbursement towards the cost of training and qualifications through the Adult Social Care Learning and Support Scheme, backed by up to £12 million in funding this financial year.

What data his Department holds on the number of healthcare professionals with specialist training in Parkinson’s disease; and whether he considers current data collection sufficient to support workforce planning for Parkinson’s services.

The Department does not collect centralised data on the number of clinicians with specific expertise in Parkinson’s disease. This is because decisions about the staffing, skill mix, and service models required to meet local population needs are made by individual National Health Service trusts and integrated care boards. These organisations are responsible for planning and commissioning services in their areas, and they determine the level of specialist expertise needed within their multidisciplinary teams. As a result, information on specialist Parkinson’s roles is held locally rather than recorded in national workforce datasets.However, we do hold data for the wider specialties central to Parkinson’s care. As of October 2025, there were 2,004 full‑time equivalent doctors in neurology and 6,324 in geriatric medicine working in NHS trusts and other organisations in England. These specialties include clinicians who provide care to people with Parkinson’s.We continue to work with NHS England through programmes such as the Neurology Transformation Programme and Getting It Right First Time to support improvements in access to specialist care. The Department has also established a United Kingdom‑wide Neuro Forum, which brings together the Government, the NHS, the devolved administrations, and neurological alliances across the four nations to share best practice and address system-wide challenges, including workforce needs for conditions such as Parkinson’s.

What steps her Department is taking to address period poverty and ensure affordable access to menstrual products.

The Government recognises the importance of women and girls being able to access the care they need for their reproductive health, including period products.We know that poverty doesn’t recognise gender, and that women and girls may suffer given the cost of period products. However, we know that period poverty reflects wider cost-of-living pressures, which is why the Government is tackling the root causes of poverty, through measures to make work pay, boosting the living wage, and investing in public services, so no one has to go without the essentials.There are a number of schemes across the Government which ensure that those who are most vulnerable can access the products they need. The Department for Education’s Period Products scheme launched in 2020 and provides free period products to girls and women in their place of study so that nobody misses out on education because of their period. Similarly, all women and girls being cared for by the National Health Service are entitled to be given, upon request, appropriate period products free of charge.We are also taking steps to ensure that products are as affordable as possible, as the tax on period products has been zero-rated since 2021, and in 2023 this was extended to include reusable period underwear.

If he will extend Business Rates reimbursements to Community Pharmacies.

In the 2025 Autumn Budget, the Government took the hard choices to protect the National Health Service in England and continue prioritising reducing waiting times. We have also stepped in to cap bills and help businesses, as part of a £4.3 billion support package.This year, we have also increased funding to community pharmacies to almost £3.1 billion, the largest uplift in funding for any part of the NHS across 2024/25 and 2025/26.The Department will consult Community Pharmacy England on any proposed changes to reimbursement and remuneration of pharmacy contractors for 2026/27 shortly.

What support is available to children in voluntary foster care who have (a) drug dependency and (b) mental health needs; and whether he has made an assessment of access to (i) therapy and (ii) treatment for such children.

The Department for Education’s National Minimum Standards for fostering makes it clear that local authorities should ensure that children in their care should have prompt access to doctors and other health professionals, including specialist services such as those supporting mental health and drug dependency, when they need these services. Further information on the National Minimum Standards for fostering is available at the following link:https://www.gov.uk/government/publications/fostering-services-national-minimum-standardsLocal authority commissioned community drug and alcohol treatment is free and accessible to all those who need it, including children and young people in voluntary foster care. Funding for alcohol and drug treatment and recovery services is provided through the Public Health Grant (PHG). In addition to the PHG, in 2025/26, the Department of Health and Social Care is providing a total of £310 million in additional targeted grants to improve drug and alcohol treatment services and recovery support to ensure that those in need can access high quality help and support. This includes children and young people with, or at risk of developing, drug and/or alcohol problems. As a result of recent increases in funding, as of August 2025, there were 4,374 more children and young people in drug and alcohol treatment. In 2024, 10% of under 18 year olds in drug and alcohol treatment were in care.For children and young people in distress or struggling with their mental health, including those in voluntary foster care, fast access to early, high-quality support is critical. That is why the 10-Year Health Plan sets out how we will work with schools and colleges to better identify and meet children's mental health needs by expanding mental health support teams in schools and colleges in England, to reach full national coverage by 2029. This will build on the work that has already begun, including providing mental health support for almost one million more young people in schools this year and investing an extra £688 million in Government funding to transform mental health services, hire more staff, and deliver more early interventions.

Whether he has made an assessment of the extent of regional variations in access to (a) shared care agreements and (b) prescribed treatments; and what steps he is taking to help ensure consistency of access to these in all integrated care boards.

Shared care arrangements between a general practitioner (GP) and a specialist are voluntary and are not part of the GP Contract. GPs do not receive additional funding for participating in shared care arrangements and may decline on clinical or capacity grounds.Guidance issued by the General Medical Council supports GPs in deciding whether to accept shared care responsibilities, ensuring that any prescriptions or referrals are clinically appropriate. Where a GP does not enter into a shared care arrangement, responsibility for ongoing treatment, including prescribing, remains with the specialist clinician.Integrated care boards (ICBs), including the NHS Surrey Heartlands ICB, are responsible for arranging health services in line with local population needs and relevant guidance. ICBs follow NHS England’s guidance on shared care protocols, including the Responsibility for Prescribing Between Primary and Secondary/Tertiary Care framework. Within the NHS Surrey Heartlands ICB this framework is overseen by the Surrey Heartlands Medicines Optimisation Group. Implementation may vary between GPs due to factors such as clinical capacity, digital infrastructure, and local agreements. Regarding funding, the ICB’s approach is consistent with national policy expectations that integrated care systems should ensure equitable access to medicines and safe, sustainable shared care arrangements.Whilst a specific assessment has not been undertaken, to support consistency of access, the Department’s Fit for the Future: 10-Year Health Plan for England, published on 3 July 2025, sets out plans for a Single National Formulary (SNF) for medicines. The SNF will replace the current system of local formularies, with a national oversight board sequencing products based on clinical and cost-effectiveness, supported by the National Institute for Health and Care Excellence. This approach is intended to drive rapid and equitable adoption of the most clinically and cost-effective medicines across England.

What steps her Department is taking to ensure that (a) NHS Surrey Heartlands Integrated Care Board and (b) other integrated care boards provide (i) adequate funding and (ii) clear guidance to general practitioners to support the implementation of shared care agreements for patients requiring ongoing medication.

Shared care arrangements between a general practitioner (GP) and a specialist are voluntary and are not part of the GP Contract. GPs do not receive additional funding for participating in shared care arrangements and may decline on clinical or capacity grounds.Guidance issued by the General Medical Council supports GPs in deciding whether to accept shared care responsibilities, ensuring that any prescriptions or referrals are clinically appropriate. Where a GP does not enter into a shared care arrangement, responsibility for ongoing treatment, including prescribing, remains with the specialist clinician.Integrated care boards (ICBs), including the NHS Surrey Heartlands ICB, are responsible for arranging health services in line with local population needs and relevant guidance. ICBs follow NHS England’s guidance on shared care protocols, including the Responsibility for Prescribing Between Primary and Secondary/Tertiary Care framework. Within the NHS Surrey Heartlands ICB this framework is overseen by the Surrey Heartlands Medicines Optimisation Group. Implementation may vary between GPs due to factors such as clinical capacity, digital infrastructure, and local agreements. Regarding funding, the ICB’s approach is consistent with national policy expectations that integrated care systems should ensure equitable access to medicines and safe, sustainable shared care arrangements.Whilst a specific assessment has not been undertaken, to support consistency of access, the Department’s Fit for the Future: 10-Year Health Plan for England, published on 3 July 2025, sets out plans for a Single National Formulary (SNF) for medicines. The SNF will replace the current system of local formularies, with a national oversight board sequencing products based on clinical and cost-effectiveness, supported by the National Institute for Health and Care Excellence. This approach is intended to drive rapid and equitable adoption of the most clinically and cost-effective medicines across England.

What recent assessment he has made of the potential impact of changes to the employers' National Insurance Contributions on providers of adult social care.

The Department routinely conducts assessments of cost pressures for local authority funded adult social care, which include the costs associated with changes to employers’ National Insurance contributions.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. There is also an extra £502 million of support for local authorities in England to manage the impact of changes to employer National Insurance contributions, as announced at the Autumn Budget.In addition, the Spending Review allows for an increase of over £4 billion of funding available for adult social care in 2028/29 compared to 2025/26.

When he plans to begin consulting with adult social care providers on proposals for a Fair Pay Agreement.

In England, we are committed to consulting on the design of the Fair Pay Agreement process, and we aim to begin a public consultation after the Employment Rights Bill receives Royal Assent later this year. We expect the consultation to run for 12 weeks, and we will work with partners to reach as much of the sector as possible.We have already begun engaging with sector representatives in England through the Department’s Fair Pay Agreement Working Group and policy specific task and finish groups, which will help to inform policy options for a public consultation on the design of the Fair Pay Agreement process.

Whether he plans to include (a) national commissioning standards for adult social care, (b) assurance and (c) oversight of adult social care commissioning in the National Care Service.

We have launched an independent commission into adult social care, chaired by Baroness Louise Casey. The commission will build a national consensus to create a National Care Service that is productive, preventative, and that gives people who draw on care, and their families and carers, more power in the system. The commission's Terms of Reference are sufficiently broad enough to enable Baroness Casey to define its remit to independently consider how to build a social care system fit for the future, including the approach to commissioning, assurance, and oversight. In the interim, we are making tangible improvements to lay the foundations for a National Care Service that will enable more people to live independently and make social care more productive. This includes driving ‘home first’ as the default option for receiving care. We have introduced a new Better Care Fund framework, for example, setting out that the National Health Service and local authorities should work together to set and meet goals, and we are backing care technologies by making it easier for everyone to identify and buy trusted solutions that help people live independently.The Care Quality Commission (CQC) has powers under the Health and Care Act 2022 to assess how well local authorities in England are performing against their duties under Part 1 of the Care Act 2014, including their duties relating to market shaping and commissioning. Formal assessments commenced in December 2023, and as of June 2025, the CQC has published over 40 local authority assessments. You can view their assessment of individual local authorities via published reports on the CQC’s website.