Written questions by Dinenage.

With reference to NHS England's Adult Social Care Activity and Finance Report, England, 2023-24, whether his Department has made an assessment of the potential implications for its policies of the decrease of 6.1% between 2022-23 and 2023-24 in local authority expenditure on support for unpaid carers.

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 local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for carers.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 Government recognises the challenges facing the adult social care system. That is why the Government is launching 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 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.We have already taken steps to support unpaid carers. From April 2025 we are increasing the Carer's Allowance weekly earnings limit from £151 a week to £196. This means carers can earn up to £10,000 a year whilst still retaining Carer's Allowance, which is approximately an additional £2,000 a year.

What assessment he has made of the potential impact of the recommendations of his Department's publication entitled JCVI statement on COVID-19 vaccination in 2025 and spring 2026, updated on 14 November 2024, on the clinically vulnerable population (a) nationally and (b) in Gosport.

The independent Joint Committee on Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation programmes. The aim of the COVID-19 vaccination programme is to prevent serious disease, leading to hospitalisation and/or mortality, arising from COVID-19.For spring 2025, as in spring 2024, the JCVI advises that a COVID-19 vaccine should be offered to: adults aged 75 years old and over; residents in a care home for older adults; and the immunosuppressed aged six months old and over.As in previous COVID-19 spring campaigns, the only clinical risk group included in the campaign are those aged six months or over with immunosuppression. The JCVI has advised that the available national data continues to demonstrate that older people and those who are immunosuppressed are at greatest risk of hospitalisation and death from COVID-19. The data available to the JCVI is national data, and they therefore made no assessment specific to Gosport.The Government accepted the independent JCVI advice for spring 2025 on 12 December 2024. The Government is considering the advice on autumn 2025 and spring 2026 carefully, and will respond in due course.

What assessment he has made with Cabinet colleagues of the adequacy of funding for local authorities to support unpaid carers who have requested a Carer's Assessment in the last 12 months.

Local authorities have duties to support people caring for their family and friends. Under the Care Act 2014, local authorities are required to undertake carer’s assessments to support people caring for their family and friends who appear to have a need for support, and to meet their eligible needs upon request from them.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. Local authorities are responsible for how they use the available funding to fulfil their duties under the Care Act 2014.The Government recognises the challenges facing the adult social care system. That is why the Government is launching 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 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.

With reference to his Department's publication entitled JCVI statement on COVID-19 vaccination in 2025 and spring 2026, updated on 14 November 2024, what the evidential basis was for accepting the JCVI’s advice on spring 2025.

The independent Joint Committee on Vaccination and Immunisation (JCVI) advises the Department on the approach to vaccination and immunisation programmes. The aim of the COVID-19 vaccination programme is to prevent serious disease, leading to hospitalisation and/or mortality, arising from COVID-19.For spring 2025, as in spring 2024, the JCVI advises that a COVID-19 vaccine should be offered to: adults aged 75 years old and over; residents in a care home for older adults; and the immunosuppressed aged six months old and over.As in previous COVID-19 spring campaigns, the only clinical risk group included in the campaign are those aged six months or over with immunosuppression. The JCVI has advised that the available national data continues to demonstrate that older people and those who are immunosuppressed are at greatest risk of hospitalisation and death from COVID-19. The data available to the JCVI is national data, and they therefore made no assessment specific to Gosport.The Government accepted the independent JCVI advice for spring 2025 on 12 December 2024. The Government is considering the advice on autumn 2025 and spring 2026 carefully, and will respond in due course.

What assessment he has made of the potential impact of levels of access to adult social care services in England on unpaid carers’ ability to participate in paid employment.

Adult social care has a role to play in helping unpaid carers to participate and stay in paid employment. The Government recognises the challenges facing the adult social care system. That is why the Government is launching 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 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.We have already taken steps to support unpaid carers to balance work and care, including from April 2025 increasing the Carer's Allowance weekly earnings limit from £151 a week to £196. This means carers can earn up to £10,000 a year whilst still retaining Carer's Allowance; this is approximately an additional £2,000 a year.I recently met with employers and the Department for Business and Trade to discuss how employers are driving best practice in supporting working carers. The Government is committed to reviewing the implementation of Carer’s Leave and examining the benefits of introducing paid Carer’s Leave.

What funding he will provide towards NHS continuing healthcare checklists over the next five years.

No funding has ever been specifically allocated for NHS Continuing Healthcare (CHC) checklists, and as such, we do not hold this information. NHS England provides funding to integrated care boards (ICBs) to fulfil their core duty to commission high-quality care in a cost-effective way. CHC funding is calculated using the ICB allocation formula, which takes into consideration attributes of the local population to assess the level of need. It is for individual ICBs to decide how best to use their allocation to deliver their functions.

What proportion of unpaid carers (a) are given practical support and (b) are signposted to information and advice following a Carer’s Assessment.

Local authorities (LAs) have duties to support people caring for their family and friends. Under the Care Act 2014, they are required to undertake Carer’s Assessments to support people caring for their family and friends who appear to have a need for support and to meet their eligible needs on request from them.In 2023/24, 360,815 carers were either supported or assessed by LAs in England. Of these, 107,935, or 30%, were provided with direct support, either via a direct payment, a managed personal budget or LA commissioned support; 199,750, or 55%, were provided with direct support in the form of information, advice, and other universal services or signposting; and 53,125, or 15%, were not provided with direct support following an assessment.Lord Darzi’s independent review of the National Health Service is clear that a fresh approach to supporting and involving unpaid carers is required to improve outcomes for carers, people needing care and the NHS.The Government recognises the challenges facing the adult social care system. That is why the Government is launching 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 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.We will carefully consider these findings as part of our 10-year plan for reforming and modernising the NHS and as we develop plans to reform adult social care, including through the National Care Service.

What discussions he has had with the Human Fertilisation and Embryology Agency on the closure of the Apricity business.

The Human Fertilisation and Embryology Authority (HFEA) advised the Department about the closure of the on-line service for fertility patients, Apricity, on 24 December 2024. The Apricity service did not fall under the HFEA’s current regulatory remit as it offered advice, diagnostic testing and prescribing but did not offer fertility treatment services directly. No discussions have therefore been held.

What assessment he has made of the adequacy of existing regulation of the fertility industry.

The Human Fertilisation and Embryology Authority (HFEA) published Modernising Fertility Law in November 2023, its recommendations for updating the regulatory framework in the Human Fertilisation and Embryology Act 1990. The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health met with the HFEA Chair on 30 July 2024 to discuss these proposals and asked for the key issues to be prioritised.The Government is currently considering this latest advice from the HFEA about the priority issues for law reform covering their regulatory powers.

Whether he plans to bring forward legislative proposals to update existing regulations in the fertility industry.

The Human Fertilisation and Embryology Authority (HFEA) published Modernising Fertility Law in November 2023, its recommendations for updating the regulatory framework in the Human Fertilisation and Embryology Act 1990. The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health met with the HFEA Chair on 30 July 2024 to discuss these proposals and asked for the key issues to be prioritised.The Government is currently considering this latest advice from the HFEA about the priority issues for law reform covering their regulatory powers.

Whether he plans to respond to the open letter by Clinically Vulnerable Families entitled Maintain Covid-19 Vaccine Access for All Clinically Vulnerable People, published on 19 November 2024.

We have received the open letter by Clinically Vulnerable Families on 14 November 2024, and will respond shortly.

Whether his Department is taking steps to encourage community organisations to register defibrillators onto the national defibrillator network.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces, and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in September 2023, the new Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The defibrillators provided through this scheme are required to be registered on The Circuit, the national defibrillator ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service. Upon registration, contact details are provided for the nominated AED guardian or guardians, who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check on the AED.The Department does not hold data on the availability of AEDs in the Gosport area, nor does it hold data on AEDs installed in Government buildings, or whether those AEDs are registered on The Circuit.

What steps his Department plans to take to help increase (a) survival rates from out-of-hospital cardiac arrests and (b) the availability of defibrillators in Gosport.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces, and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in September 2023, the new Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The defibrillators provided through this scheme are required to be registered on The Circuit, the national defibrillator ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service. Upon registration, contact details are provided for the nominated AED guardian or guardians, who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check on the AED.The Department does not hold data on the availability of AEDs in the Gosport area, nor does it hold data on AEDs installed in Government buildings, or whether those AEDs are registered on The Circuit.

Whether recipients of the community automated external defibrillator (AED) fund are required to register their AEDs onto the national defibrillator network.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces, and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in September 2023, the new Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The defibrillators provided through this scheme are required to be registered on The Circuit, the national defibrillator ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service. Upon registration, contact details are provided for the nominated AED guardian or guardians, who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check on the AED.The Department does not hold data on the availability of AEDs in the Gosport area, nor does it hold data on AEDs installed in Government buildings, or whether those AEDs are registered on The Circuit.

Whether automated external defibrillators that are installed on Government buildings are registered with the national defibrillator network.

The Government is committed to improving access to Automated External Defibrillators (AEDs) in public spaces, and reducing inequalities in access to these life saving devices. Following the depletion of the existing AED fund, launched in September 2023, the new Government approved a further £500,000 in August 2024 to fulfil existing applications to the fund.The defibrillators provided through this scheme are required to be registered on The Circuit, the national defibrillator ambulance service database, operated independently by the British Heart Foundation in collaboration with the National Health Service. Upon registration, contact details are provided for the nominated AED guardian or guardians, who are local to the defibrillator’s location and conduct checks when required. The registered guardian receives an automatic email or text message notification if the defibrillator has potentially been used, therefore prompting the guardian to conduct a check on the AED.The Department does not hold data on the availability of AEDs in the Gosport area, nor does it hold data on AEDs installed in Government buildings, or whether those AEDs are registered on The Circuit.

If he will take steps to help ensure that people with Down Syndrome can receive direct payments from local councils.

Under the Care Act 2014, local authorities should allow those drawing on care to receive their personal budget as a direct payment, where they are satisfied this would be suitable to meet their eligible care needs, and where they have capacity under the conditions of the 2005 Mental Capacity Act to make this request, and manage the direct payment either themselves, with aide from an authorised person, or through an authorised person acting on their behalf.Additionally, under the Down Syndrome Act 2022, my Rt Hon. Friend, the Secretary of State for Health and Social Care is required to give guidance to the relevant authorities in health and social care on what they should be doing to meet the needs of people with Down syndrome. Officials are taking forward, as a priority, development of Down Syndrome Act guidance. We expect to publish the draft guidance for public consultation in the new year.

What steps he is taking to improve treatment pathways for (a) PANS and (b) PANDAS patients.

The Department recognises the importance of raising awareness of rare diseases such as paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) among healthcare professionals and improving the health and care system for people living with such conditions. We are supportive of the progress made by PANS PANDAS UK and the PANS PANDAS Steering Group to undertake a national surveillance study, develop a clinical guideline and produce guidance for professionals, children, young people and families.

What steps his Department is taking to reduce waiting times for joint replacement surgery in Gosport constituency.

Tackling waiting lists is a key part of our Health Mission and a top priority for the Government, including waits for joint replacement surgery. We have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment by the end of this Parliament. As a first step, we will deliver an additional 2 million operations, scans, and appointments during our first year in Government, which is the equivalent to 40,000 per week.We are also supporting dedicated and protected surgical hubs to help reduce elective surgery wait times, including for joint replacement, by focusing on high volume low complexity surgeries, as recommended by the Royal College of Surgeons of England, transforming the way the National Health Service provides elective care.As of November 2024, there are currently 110 operational surgical hubs across England. There are currently two operational surgical hubs within the Hampshire and the Isle of Wight Integrated Care System offering trauma and orthopaedics services, including joint replacement, those being the Lymington Hospital Elective Hub, and the Winchester Country Hospital Elective Hub. Patients in the Gosport constituency can be referred to the two surgical hubs for trauma and orthopaedics services.The Department and NHS England will set out details on the allocation of further funding at the earliest opportunity, including how many new surgical hubs will be established.

Whether his Department is providing financial resources to integrated care boards to allow them to allocate resources effectively.

The Department provides funding to NHS England, which in turn allocates a large part of its funding to the integrated care boards. Planned spend by integrated care boards is currently £141 billion for the financial year 2024/25, with boards responsible for the strategic commissioning of services to meet the needs of their local populations.

What recent assessment his Department has made of the adequacy of the availability of fracture liaison services in Gosport constituency.

The Government recognises the current postcode lottery for access to quality Fracture Liaison Services in constituencies across the country. That is why the Government is committed to their expansion, and the Department is working closely with NHS England on how to ensure better quality and access, including ways to best support local systems.Fracture Liaison Services are commissioned by integrated care boards who are best placed to make decisions according to local need. The Falls and Fragility Fracture Audit Programme, which includes a dedicated Fracture Liaison Service database, is a national clinical audit of fracture prevention care, delivered by the Royal College of Physicians. This includes reporting on individual Fracture Liaison Services, and supports local and national service improvement.