Written questions by Morello.

Whether his Department plans to provide support to the Global Surgery Network for projects in (a) Nigeria, (b) India, (c) Mexico and (d) other countries.

The National Institute for Health and Care Research (NIHR)-funded Global Health Research Unit on Global Surgery was originally awarded over £6.9 million in 2017 with further funding of £7 million awarded in 2021 to establish a Global Surgery Network. The latest funding contract ends in June 2026. We encourage members to look out for and apply for future NIHR funding opportunities to build upon their strong foundations and continue to drive an evidence-informed approach to surgery. Applications to NIHR funding schemes are subject to peer review and judged in open competition. The Department and NIHR continue to recognise the critical importance of global health research to drive the health and well-being of the poorest and most vulnerable.

Whether his Department has had discussions with Jhoots Pharmacy on unpaid (a) staff wages and (b) suppliers.

National Health Service pharmaceutical services, the staff who provide them, and the community pharmacies from which they are delivered are regulated. The entire system is laid out in legislation and is subject to assurance and inspection by both integrated care boards (ICBs) and the General Pharmaceutical Council.ICBs are responsible for monitoring that contractors are adhering to their NHS terms of service, investigating and acting in cases of non-compliance. ICBs are also responsible for determining applications for new pharmacies including changes of ownership. The legislative framework is under constant review and is updated as required.The Department does not make assessments of the suitability of individual pharmacy contractors. The Department also does not engage directly with individual pharmacy contractors to discuss matters like unpaid staff or suppliers.

What steps his Department is taking to ensure that the criteria for approving operators to take over NHS community pharmacies is sufficiently robust to prevent service failures.

National Health Service pharmaceutical services, the staff who provide them, and the community pharmacies from which they are delivered are regulated. The entire system is laid out in legislation and is subject to assurance and inspection by both integrated care boards (ICBs) and the General Pharmaceutical Council.ICBs are responsible for monitoring that contractors are adhering to their NHS terms of service, investigating and acting in cases of non-compliance. ICBs are also responsible for determining applications for new pharmacies including changes of ownership. The legislative framework is under constant review and is updated as required.The Department does not make assessments of the suitability of individual pharmacy contractors. The Department also does not engage directly with individual pharmacy contractors to discuss matters like unpaid staff or suppliers.

Whether he has made an assessment of the the suitability of Jhoots Pharmacy as a provider of NHS pharmacy services.

National Health Service pharmaceutical services, the staff who provide them, and the community pharmacies from which they are delivered are regulated. The entire system is laid out in legislation and is subject to assurance and inspection by both integrated care boards (ICBs) and the General Pharmaceutical Council.ICBs are responsible for monitoring that contractors are adhering to their NHS terms of service, investigating and acting in cases of non-compliance. ICBs are also responsible for determining applications for new pharmacies including changes of ownership. The legislative framework is under constant review and is updated as required.The Department does not make assessments of the suitability of individual pharmacy contractors. The Department also does not engage directly with individual pharmacy contractors to discuss matters like unpaid staff or suppliers.

What steps his Department is taking to ensure continuity of access to prescription medicines in towns where a single operator pharmacy fails to meet its contractual obligations.

National Health Service pharmaceutical services, the staff who provide them, and the community pharmacies from which they are delivered are regulated. The entire system is laid out in legislation and is subject to assurance and inspection by both integrated care boards (ICBs) and the General Pharmaceutical Council.ICBs are responsible for monitoring that contractors are adhering to their NHS terms of service, investigating and acting in cases of non-compliance. ICBs are also responsible for determining applications for new pharmacies including changes of ownership. The legislative framework is under constant review and is updated as required.The Department does not make assessments of the suitability of individual pharmacy contractors. The Department also does not engage directly with individual pharmacy contractors to discuss matters like unpaid staff or suppliers.

Whether he plans to publish a description of the new job role for physician associates before implementation of the Leng Review.

NHS England has published a letter and a ‘Frequently Asked Questions’ document, setting out what the accepted Leng Review recommendations mean for employees and employers, both in the immediate and longer term. The document is available at the following link:https://www.england.nhs.uk/wp-content/uploads/2025/07/leng-review-nhs-england-faqs-on-actions-for-nhs-organisations.pdfNHS England will consider the development of new model job descriptions for the roles of physician assistants (PAs) and physician assistants in anaesthesia (PAAs), still legally known as anaesthesia associates and physician associates, in consultation with key partners as part of any wider implementation plan. Whilst such model job descriptions would not be mandatory, they would provide guidance on the general duties of newly qualified PAs and PAAs for employers when recruiting.Prior to implementing new job descriptions, these should be evaluated either through local primary care approaches or the National Health Service job evaluation scheme for secondary care providers.In the meantime, employers of the roles should ensure their competencies and job activities are assessed to ensure they are appropriate, reflect the required work activities within the service, and that clinical governance and oversight of the roles is clearly documented.

Whether funding is available to upgrade hospital helipads to enable night-time operation.

Hospital helipads can be funded via several routes, including by National Health Service trusts, charities, and donors. NHS trusts, working with integrated care systems, can use their local capital budgets to support investment in helipads where these are a local priority, either directly or as part of larger infrastructure projects. Decisions on upgrading hospital helipads are taken at a local level.

What the difference is between per-patient spend in (a) each hospital, (b) the average per-patient spend of hospitals in the top quarter of efficiency and (c) the average per-patient spend of hospitals in the bottom quarter of efficiency.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

What the average per-patient spend is per hospital (a) in England and (b) within the top quarter of most efficient hospitals.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

What estimate he has made of the potential financial impact of aligning funding to the average per-patient spend of the top quarter most efficient hospitals on rural hospitals.

The basis of the funding allocated to providers is set out in the National Payment Scheme, with further information available at the following link:https://www.england.nhs.uk/pay-syst/nhs-payment-scheme/This includes setting out the prices paid where funding varies with activity, and these prices are the same for all providers. They are based on average costs across National Health Service providers rather than top quarter performance. We have not directly assessed the impact of changing the payment scheme to set prices based on the top quarter of the most efficient providers. However, NHS England sends packs to all NHS providers quantifying productivity and efficiency opportunities based on metrics in the Model Health System dataset. This allows individual providers, including those in rural areas, to benchmark themselves against others, and measure the financial impact of improving performance.

What comparative assessment he has made of the efficiency (a) rural and (b) urban hospitals; and how many hospitals in each of those categories are within the top quarter most efficient hospitals.

As part of the 2025/26 planning process, all National Health Service organisations were required to set efficiency and savings targets necessary to achieve a balanced financial position. These targets are publicly available in hospital board reports. The Department and NHS England do not assess hospital performance based solely on efficiency. Instead, the NHS Oversight Framework (NOF) measures NHS trust and foundation trust performance across a range of metrics. These reflect the delivery of NHS priorities, including performance against targets like reducing wait times for electives and accident and emergency, and improving ambulance response times.The NOF assigns trusts to four equal-sized performance categories called ‘segments’. NHS England has also recently published newly developed league tables to bring greater transparency to NHS performance at a provider level.

What steps he is taking to help ensure that existing hospital helipads are protected from (a) planning and (b) operational restrictions.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

Whether he will make an assessment of the potential merits of introducing legislative safeguards to protect existing hospital helipads from closure.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

How and what proportion of major trauma hospitals operate 24-hour hospital helipads in England.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

If he will make it his policy that all major trauma hospitals to have access to 24-hour helipad facilities.

Air ambulances form a vital part of the emergency response to patients in critical need. The Department of Health and Social Care continues to work closely with NHS England and the Department for Transport to ensure that there is appropriate helipad accessibility available for air ambulances across the country. However, there are no plans to make it national policy that all major trauma hospitals have access to 24-hour helipad facilities.The Department of Health and Social Care is working with the Ministry of Housing, Community and Local Government to support and promote the interests of the health and care system throughout the planning process, including improving the participation of all relevant health stakeholders in the creation of local plans to ensure that necessary service provision is maintained. Information on the proportion of major trauma hospitals that operate 24-hour hospital helipads in England is not held centrally.

What the average per-patient spend is in (a) all hospitals and (b) the top quartile of efficient hospitals.

NHS England collects information on the costs of NHS trusts delivering services to patients, the detail of which is available at the following link: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/.Comparing the average cost per patient per hospital is not meaningful, because to ensure fair comparisons, differences in service mix and patient complexity must be taken into account and this varies significantly across hospitals. The costing data does however enable comparisons of the costs of certain activities, or episodes of care, across different providers.The National Cost Collection Index (NCCI) compares a trust’s average cost with the national average cost for that service across all the services it delivers. An NCCI value of 110, for example, means that the trust has costs that are 10% more expensive than the national average (adjusted for its mix of services and patient complexity).

Which hospitals are in the top quartile of most efficient hospitals.

The Department and NHS England do not measure efficiency by hospital. Instead, the NHS Oversight Framework measures National Health Service trust and foundation trust performance across a range of metrics. These reflect the delivery of NHS priorities, including performance against targets like reducing wait times for electives and accident and emergency, and improving ambulance response times.The framework assigns trusts to four equal-sized, or quartiled, performance categories referred to as segments. This year’s framework, however, emphasises the importance of maintaining financial control by limiting providers to no higher than segment 3 if they are not delivering a surplus or breakeven position.Segmentation under this year’s framework has now been published as part of newly developed league tables, designed to increase transparency and drive improvement. These tables are available at the following link:https://www.england.nhs.uk/publication/nhs-oversight-framework-nhs-trust-performance-league-tables-process-and-results/

Whether his Department has made an estimate of the potential impact of his proposed reforms to the Physician Associate role on the number of redundancies of Physician Associates.

The principle question of the Leng Review was to assess whether the roles of physician and anaesthesia associate, which we recommend should now be known as physician assistants and physician assistants in anaesthesia, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams. NHS England has written to National Health Service trusts, integrated care boards, and primary care networks reiterating their responsibilities to their staff as employers, including providing pastoral support where required. Importantly, it has also written directly to the staff most affected by the recommendations setting out where they can find support if required. Whilst decisions about recruitment are a matter for individual NHS employers at a local level, physician assistants, and physician assistants in anaesthesia, can play a vital role in the delivery of the shifts set out in the 10-Year Health Plan for England. Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.

What steps he plans to take to implement the recommendations of the Independent review of the physician associate and anaesthesia associate roles, published on 16 July 2025.

The Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. The Department, alongside NHS England, royal colleges, and other stakeholders including representatives of doctors, physician assistants, and physician assistants in anaesthesia, will develop a detailed implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course. The Government intends to commence consultation on a modernised legislative framework for the General Medical Council by the end of this year. These proposals will include the change in role titles. Subject to parliamentary time, our expectation is that these changes will be put before the Westminster and Scottish Parliaments during 2026.

Whether his Department plans to consult with stakeholders before implementing changes to the (a) role and (b) title of Physician Associates.

The Leng Review’s recommendations are far reaching and require cross-system partnership working to be considered, planned, and delivered effectively. The Department, alongside NHS England, royal colleges, and other stakeholders including representatives of doctors, physician assistants, and physician assistants in anaesthesia, will develop a detailed implementation plan to address the review’s 18 recommendations. Further information on implementation will be set out in due course. The Government intends to commence consultation on a modernised legislative framework for the General Medical Council by the end of this year. These proposals will include the change in role titles. Subject to parliamentary time, our expectation is that these changes will be put before the Westminster and Scottish Parliaments during 2026.