Written questions by Snowden.

What steps he is taking to ensure that the rise in employers’ National Insurance contributions does not disproportionately impact (a) smaller GP practices and (b) independent contractors.

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. The global sum allocation formula, which underpins capitation payments to GPs, is designed to ensure that resources are directed to practices based on an estimate of their patient workload and unavoidable practice costs. This takes into account factors such as age and sex composition of registered patients, and additional pressures caused by factors such as geographical location and patient turnover. We are committed to ensuring that primary medical services receive appropriate support and resources. 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.

Pursuant to the Answer of 3 April 2025 to Question 42350 on General Practitioners: Employers' Contributions, what assessment he has made of the merits of feedback received from the General Practitioners Committee England during the consultation on GP services; and what steps he has taken to incorporate this feedback into the new contract.

Every year the Department and NHS England consult with the General Practitioners’ Committee (GPC), of the British Medical Association (BMA), to discuss the services general practitioners (GPs) will be expected to provide and the funding they will receive in return under the GP Contract. Feedback from the GPC is considered as part of this process and we are pleased that the GPC is supportive of the changes made to the 2025/26 GP Contract.

Pursuant to the Answer of 22 May 2025 to Question 51548 on Primary Care: Lancashire, what steps his Department is taking to increase the number of GPs in Fylde constituency.

We have committed to training thousands more general practitioners (GPs) across the country, including in Fylde, which will increase capacity and take the pressure off those currently working in the systemThe 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 secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified GPs for which primary care networks are claiming reimbursement via the ARRS shows that since 1 October 2024, over 1,700 GPs were recruited through the scheme.We are investing an additional £889 million through the GP Contract to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.

If he will make an assessment of the potential merits of expanding the number of skincare conditions that can be treated through Pharmacy First.

The Pharmacy First service allows for referrals from NHS111, general practitioners and accident and emergency for advice on a minor illness, which includes a number of skin conditions and may also include the sale of over-the-counter medicines.Currently the clinical pathways element of the service that allows for the supply of prescription-only medicines covers seven common health conditions, including sinusitis, sore throat, earache, impetigo, shingles, infected insect bites and uncomplicated urinary tract infections in women aged between 16 and 64 years old. NHS England is keeping the clinical scope of this part of the service under review.

Pursuant to the Answer of 3 April 2025 to Question 42350 on General Practitioners: Employers' Contributions, how much and what proportion of the £889 million will be spent on (a) staffing, (b) technology, (c) patient access and (d) other services.

We are investing an additional £889 million in general practices (GPs) to reinforce the front door of the National Health Service, 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. GPs are independent contractors, so the application of any non-ringfenced funding they receive via the contract is at their discretion, to best meet the demand of their patients. Some elements of the £889 million investment have been specified or ringfenced. £228 million has been made available for pay uplifts. A further £176 million has been provided for Additional Roles Reimbursement Scheme staff, which now includes GPs and practice nurses, and is worth £1.7 billion in 2025/26. In addition, we estimate that £13.2 million will be used to uplift locum reimbursement rates, which were agreed as part of the contract. Additionally, we are accepting the Doctors’ and Dentists’ Pay Review Body’s recommendation of a 4% increase to the pay element of the GP Contract, backdated to 1 April 2025. This will mean an increase in the £889 million contract investment, which was based on a 2.8% pay assumption. £17.8 million has been used to increase the item of service fee for routine childhood vaccinations, and in addition to the £889 million, a further £80 million has been provided to support patient services through the advice and guidance enhanced service.

What steps he is taking to ensure the sustainability of funding for general practice beyond 2025/26 in the context of (a) rising demand for services and (b) increasing operational costs.

Departmental budgets beyond 2025/26 will be set through Phase 2 of the Spending Review, which will conclude and be published in June.The Department is committed to ensuring that primary care services receive appropriate support and resources. Every year the Department and NHS England consult with the General Practitioners’ Committee of the British Medical Association to discuss the services practices are expected to provide, and the funding they will receive in return. The operating costs for practices are taken into account as a part of this process.

What support his Department provides to help small and micro food businesses to (a) understand and (b) comply with food hygiene certification requirements.

The Food Standards Agency (FSA) has developed and published many materials on the FSA website to support businesses to meet the requirements set out in food hygiene legislation. The website is available at the following link:http://www.food.gov.uk/We know that small and micro businesses can face additional challenges when trying to access and understand legal requirements, so there are several free tools which have been designed to guide small and micro businesses including Safer Food Better Business (SFBB), as well as Safe Catering Guidance for Northern Ireland.The practical and easy-to-use packs will help small businesses to:- comply with food hygiene regulations;- show what they need do to make and store food safely including how to clean effectively;- train staff and support them to use good hygiene practices;- protect business's reputation; and- improve food hygiene rating scores. There are also additional supplementary packs for SFBB available to support sectors such as childminders, residential care homes, retailers, and businesses serving Indian and Chinese cuisines.In addition, the FSA website has a dedicated Business Guidance section which provides information such as how to start a food business safely, starting a food business from home and selling food for delivery. It hosts free online food safety courses on allergen management and root cause analysis.The FSA regularly runs campaigns across various social media platforms to inform food businesses of the available materials to support their compliance with hygiene requirements.

Pursuant to the Answer of 22 May 2025 to Question 51548 on Primary Care: Lancashire, whether the pilot programme to screen patients for cardiovascular disease within optometry practices will take place in Fylde constituency.

The optometry pilot is an NHS England programme. The pilot is not taking place in Fylde; in Lancashire and South Cumbria four areas are participating in the pilot which will run until September 2025 (Fleetwood in Wyre; Burnley in East Lancashire; Blackburn in Blackburn with Darwen; and Central Preston).Expressions of interest were open to all areas and the final pilot areas were chosen by NHS England based on prevalence of hypertension and deprivation (IMD 1&2).Further roll out will be dependent on the outcomes of the pilot and future funding.

What steps his Department is taking to help support care homes to (a) address workforce shortages and (b) provide high-quality care for elderly people in Fylde constituency.

English local authorities have responsibility under the Care Act 2014 to meet social care needs and statutory guidance directs them to ensure there is sufficient workforce in adult social care (ASC).The Government recognises the scale of reforms needed to make the ASC sector attractive, to support sustainable workforce growth and improve the recruitment and retention of the domestic workforce. This is why we are introducing the first ever Fair Pay Agreement to the ASC sector so that care professionals are recognised and rewarded for the important work that they do.The Care Quality Commission (CQC) is the independent regulator for health and social care in England. CQC Regulation 18 states that providers must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. Where the CQC finds a breach in this regulation, it can take regulatory action to ensure the safety of people drawing on care and support.

What steps he is taking to reduce physical inactivity in older people.

The Government and the National Health Service recognise that prevention will always be better and cheaper than treatment. Reducing physical inactivity in people of all ages, including in older people, is important in helping people live longer, healthier lives, and a key part of the Department’s shift from treatment to prevention.The NHS Better Health Campaign promotes ways for people of all ages to move more, and signposts to digital support like the NHS Active 10 walking app, an accessible way of building movement into everyday life.The NHS, together with local authorities, provides a range of services to support older people, such as exercise on referral and social prescribing, aquatic/swimming classes, dance classes, and fall prevention training through strength and balance classes.

What steps he is taking to improve mental health services in (a) Fylde constituency and (b) across Lancashire.

Too many people with mental health issues are not getting the support or care they need, including in the Fylde constituency and across Lancashire, and we know that waits for mental health services are far too long. We are committed to improving mental health care for people with a range of mental health conditions, and to shifting the focus from treatment to prevention as we make the National Health Service fit for the future. Our reforms to the Mental Health Act will give patients a greater say in their care and will ensure that people get the appropriate and compassionate mental health support they need. We have also launched 24/7 mental health crisis support services via NHS 111, and we will recruit 8,500 mental health staff, create a network of community Young Futures Hubs, and provide access to mental health support in every school.

What steps he is taking to improve primary care in (a) Fylde constituency and (b) Lancashire.

The Department is committed to ensuring that primary care services receive appropriate support and resources. We are investing an additional £889 million in general practice to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade and means we are reversing the recent trend with a rising share of total NHS resources going to general practice.The Government has invested £82 million in the Additional Roles Reimbursement Scheme, which has enabled the recruitment of over 1,500 recently qualified general practitioners (GPs) across England since October 2024. This will increase the number of available appointments, secure the future supply of GPs and alleviate the pressure on those currently working in the system.For 2025/26, funding for the core community pharmacy contractual framework has been increased to £3.073 billion. This represents an uplift in funding of over 19% across 2024/25 and 2025/26.This Government plans to tackle the challenges for patients trying to access NHS 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 improve primary care, I understand Lancashire and South Cumbria (LSC) Integrated Care Board (ICB) has produced 2030 road maps for each professional group, designed to maximise skills and increase services provided. These plans are for the whole ICB footprint, including Fylde. Highlights from the plan include: the introduction of standard local enhanced services across LSC ensuring consistency of care for patients and increased funding to practices from 25 May 2025; redesigned urgent primary care access hubs from April 2027; increasing uptake of the Pharmacy First service; pilot programme to screen patients for cardiovascular disease within optometry practices; and implementation of the integrated dental access programme targeting care to those most at need.

Pursuant to the Answer of 27 March 2025 to Question 39625 on General Practitioners: Employers' Contributions, whether he has made an assessment of the potential impact of the proposed increase to employers' National Insurance contributions on the level of employment in general 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 through the GP Contract 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.

Pursuant to the Answer of 27 March 2025 to Question 39625 on General Practitioners: Employers' Contributions, whether he has made an assessment of the potential impact of the proposed increase to employers' National Insurance contributions on the number of general practices.

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 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 through the GP Contract 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 assessment he has made of the potential impact of the proposed increase to employers National Insurance contributions on hospices in Lancashire.

We have taken necessary decisions to fix the foundations in the public finances at the Autumn Budget, enabling the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26.The employer National Insurance contribution rise will be implemented in April 2025, and planning guidance published on 30 January 2025 sets out the funding available to integrated care boards and the overall approach to funding providers in the next financial year. It considers a variety of pay and non-pay factors and pressures on providers of secondary healthcare, including charitable hospices. Further information on the planning guidance is available at the following link: https://www.england.nhs.uk/publication/2025-26-priorities-and-operational-planning-guidance/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. We are pleased to confirm that the Government has released the first £25 million tranche of that funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be available from April 2025.We are also 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.

What steps he has taken to increase NHS capacity for winter 2025-26 in Fylde constituency.

Local National Health Service winter resilience plans for the Flyde area specifically are an operational matter for NHS Lancashire and South Cumbria Integrated Care Board (ICB) working in partnership with local NHS providers. The ICB’s planning for 2025/26 is ongoing, including the allocation of £24 million of capital funding to improve urgent and emergency care services.At national level, we have communicated priorities for urgent and emergency care this year through the NHS England mandate and the operational planning guidance for 2025/26. We will shortly set out further actions and improvements to be taken this year to support urgent and emergency care services.

Whether he has made an assessment of the potential impact of the proposed increase in employer National Insurance contributions on social care providers in Fylde constituency.

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.The additional funding available to Lancashire in 2025/26 means that they will see an increase to their core spending power of up to 7.3% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

What assessment he has made of the potential impact of the proposed increase to employers National Insurance contributions on general practices in Fylde constituency.

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 will be 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 through the GP Contract 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 he is taking to improve the safety of NHS maternity services in Fylde constituency.

The Blackpool Teaching Hospitals NHS Foundation Trust entered the national Maternity Safety Support Programme (MSSP) in September 2022, following a Care Quality Commission inspection earlier that month which rated Blackpool Victoria Hospital’s maternity services in the Fylde constituency as ‘requires improvement’ overall. The programme provides intensive support to the trust to assist in the improvement of their maternity services, including a dedicated Maternity Improvement Advisor and support to implement a tailored improvement plan. A full diagnostic assessment has identified key areas of focus with an associated improvement plan and agreed exit criteria.The Local Maternity and Neonatal System arm of the Lancashire and South Cumbria Integrated Care Board receives reports from the MSSP, so it can support the service with focused improvement work.A MSSP assurance visit on 27 January 2025 concluded that significant improvements had been made across a number of areas, with evidence of data demonstrating sustained improvement. The next review meeting for the service is to take place on 28 May 2025.

What his planned timeline is for implementing gastroenterology reforms through the Elective Care Reform Programme; and how he plans to monitor progress.

We have prioritised cutting waiting lists and getting back to the standard that at least 92% of people should wait no longer than 18 weeks from referral to treatment. We have delivered an extra 2.5 million operations, scans, and appointments between July and December 2024 compared to the same period in 2023; this means that last month we hit our committment seven months early.We recently published the Elective Reform Plan which sets out the reform and productivity efforts needed to return to the 18-week standard. One of the major commitments in the plan is to enhance clinically led pathways to shift care from hospital to community, including gastroenterology pathways.Specifically, the plan commits to pathway reform starting in five areas, with gastroenterology being one. The commitment is to develop an integrated pathway across primary, community and secondary care for common gastroenterology conditions. We will also drive the rapid adoption of remote monitoring in appropriate gastroenterology pathways, which reduces consultant-led outpatient appointments by over 50%. Work is underway, including with the Royal Colleges, and further information will be forthcoming as plans are developed.The plan also reinforces the Government’s commitment to work with patients, carers and their representatives to publish the standards patients should expect to experience while they wait for care, including for those waiting for gastroenterology services. We will continue to work with patients and carers to build on this work and establish a gold standard for experience.