Written questions by Stafford.

What steps his Department is taking to ensure that (a) Lecanemab and (b) other new treatments for Alzheimer’s disease are made accessible to eligible patients through the NHS.

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service in England on whether new medicines should be routinely funded based on an assessment of their costs and benefits. The NICE evaluates all new medicines, including medicines for the treatment of Alzheimer’s disease, and aims to publish guidance for the NHS as close as possible to licensing. The NHS in England is legally required to fund recommended treatments, normally within three months of the publication of final guidance.The NICE concluded that the evidence presented so far shows that neither donanemab nor lecanemab provide enough benefit to justify the substantial resources the NHS would need to commit to implement access to them. The NICE has not yet published final guidance on either medicine, and its independent Appraisal Committee will meet on 14 May to consider the responses to its recent consultation.To prepare for the new generation of dementia treatments in development, NHS England is working to ensure the diagnostic and treatment capacity, clinical pathway redesign, and investments are in place to support the adoption of any new licensed and NICE-recommended treatments as soon as possible.

Whether his Department plans to reinstate a national target for local health systems to improve dementia diagnosis rates in future iterations of the NHS Operational Planning Guidance.

The Government and NHS England remain committed to recovering the dementia diagnosis rate to the national ambition of 66.7%.The NHS Operational Planning Guidance is not an exhaustive list of everything the National Health Service does, and the absence of a target does not mean it is not an area of focus. We have yet to take decisions on future iterations of the guidance.

What assessment his Department has made of the potential impact of the proposed abolition of NHS England on healthcare suppliers; and whether he plans to publish guidance on changes to (a) procurement systems, (b) leadership structures and (c) the NHS supply chain to support business (i) planning and (ii) continuity.

Ministers and senior Department officials will work with the new executive team at the top of NHS England, led by Sir Jim Mackey, to lead the formation of a new joint centre. As we work to bring the two organisations together, we will ensure that we continue to evaluate impacts of all kinds, which includes working with healthcare suppliers and the future organisation and leadership of procurement systems and National Health Service supply chains.The abolition of NHS England will strip out the unnecessary bureaucracy and cut the duplication that comes from having two organisations doing the same job, and we will empower staff to focus on delivering better care for patients, driving productivity up, and getting waiting times down.

What steps his Department is taking to reduce waiting times for mental health treatment; and when he plans to set out further measures to reduce delays for patients in need of support.

Too many people with mental health issues are not getting the support or care they need, which is why we are committed to ensuring we give mental health the same attention and focus as physical health so that people can be confident of accessing high quality mental health support when they need it.As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, the Government will recruit 8,500 mental health workers to help ease pressure on busy mental health services.Despite the challenging fiscal environment, the Government has chosen to prioritise the funding to deliver expansions of NHS Talking Therapies and Individual Placement & Support schemes, demonstrating our commitment to addressing the root cause of mental health issues and providing support for people with severe mental illness to contribute to the economy by remaining in or returning to work.We have also committed £26 million in capital investment to open new mental health crisis centres, reducing pressure on busy emergency mental health and accident and emergency services and ensuring people have the support they need when they need it.

What recent assessment he has made of the adequacy of the availability of Estradot hormone replacement therapy patches; and what steps he is taking to ensure consistent supply for patients.

There are over 70 hormone replacement therapy (HRT) products, and the vast majority are in good supply. Previously there has been issues with the supply of a limited number of these products, primarily driven by very sharp increases in demand. Following the Department’s intensive engagement with industry, the supply position has improved considerably. As part of this we have previously met with suppliers on a very regular basis and have held nine HRT supply roundtables since April 2022, with the most recent in September 2024, with suppliers, wholesalers, and community pharmacists, to provide updates on the supply position and the actions being taken to address them, to share data, and to discuss relevant policy developments and potential impacts.Currently, there are limited supplies of Estradot (estradiol) 37.5, 50, 75, and 100 microgram/24 hour patches, which may be available to local pharmacies to order. We are working with the sole supplier of Estradot to expedite further resupplies where possible. Further deliveries of all patches are expected in late April 2025, except for the 37.5 microgram/24 hour patches, which will be resupplied in July 2025.We have issued comprehensive management guidance to the National Health Service, including Serious Shortage Protocols for some, allowing community pharmacists to supply the equivalent strength patch of an alternative brand without the need for a new prescription.

Whether his Department has made an assessment of the adequacy of the consultation process undertaken by Hampshire and Isle of Wight Integrated Care Board in advance of its decision to cancel primary eyecare contracts from April 2025.

Integrated care boards are responsible for commissioning both primary and secondary eye care services in their areas to meet local needs.

Whether his Department has issued guidance to Integrated Care Boards on the (a) retention of and (b) commissioning of new (i) community urgent eyecare services, (ii) glaucoma monitoring and (iii) other community-based eyecare services.

Integrated care boards are responsible for commissioning both primary and secondary eye care services in their areas to meet local needs.

What steps his Department is taking to support NHS Trusts to use existing estate and equipment for insourced clinical activity during off-peak hours.

The Government supports efforts to utilise National Health Service capacity out of hours and over weekends, where it is a cost-effective and sustainable means of delivering additional activity. The most cost-effective route to do this is best determined at a local level, where integrated care boards and trusts can evaluate the options available to them.We recognise insourcing as an opportunity to maximise productivity and efficiency and published guidance in 2024 to promote the effective utilisation of their services, available at the following link:https://www.england.nhs.uk/long-read/guidance-for-trusts-on-the-use-of-insourcing/The guidance is clear that, to promote value for money being achieved, arrangements should be at or below the unit prices set out in the NHS payment scheme. The guidance also asks all trusts to ensure that appropriate due diligence is undertaken before utilising insourcing solutions, including ensuring pay rates are at or below NHS England’s agency price caps.This guidance sits alongside the Insourcing of Clinical Services Framework Agreement, published by NHS Shared Business Services, which supports local NHS organisations with the timely procurement of services, and which is available at the following link:https://www.sbs.nhs.uk/services/framework-agreements/insourcing-of-clinical-services/We have set clear elective priorities for the system in the Elective Reform Plan and 2025/26 Planning Guidance, including that every trust will need to deliver a minimum 5% improvement by March 2026. We expect trusts to be using all levers to deliver this.

What assessment his Department has made of the potential cost-effectiveness of NHS insourcing as a means to reduce elective waiting lists.

The Government supports efforts to utilise National Health Service capacity out of hours and over weekends, where it is a cost-effective and sustainable means of delivering additional activity. The most cost-effective route to do this is best determined at a local level, where integrated care boards and trusts can evaluate the options available to them.We recognise insourcing as an opportunity to maximise productivity and efficiency and published guidance in 2024 to promote the effective utilisation of their services, available at the following link:https://www.england.nhs.uk/long-read/guidance-for-trusts-on-the-use-of-insourcing/The guidance is clear that, to promote value for money being achieved, arrangements should be at or below the unit prices set out in the NHS payment scheme. The guidance also asks all trusts to ensure that appropriate due diligence is undertaken before utilising insourcing solutions, including ensuring pay rates are at or below NHS England’s agency price caps.This guidance sits alongside the Insourcing of Clinical Services Framework Agreement, published by NHS Shared Business Services, which supports local NHS organisations with the timely procurement of services, and which is available at the following link:https://www.sbs.nhs.uk/services/framework-agreements/insourcing-of-clinical-services/We have set clear elective priorities for the system in the Elective Reform Plan and 2025/26 Planning Guidance, including that every trust will need to deliver a minimum 5% improvement by March 2026. We expect trusts to be using all levers to deliver this.

What assessment his Department has made of the potential impact of the withdrawal of commissioned primary eyecare services from April 2025 by Hampshire and Isle of Wight Integrated Care Board on NHS hospital eye services.

Integrated care boards are responsible for commissioning both primary and secondary eye care services in their areas to meet local needs.

What estimate his Department has made of the number of procedures deliverable per £1 million of Departmental spend via (a) NHS internal delivery, (b) outsourcing and (c) insourcing.

The National Health Service’s national cost collection gives a national average unit cost of £751 across all planned procedures within outpatients, day cases, and elective inpatient settings in 2023/24. This is the equivalent to 1,331 procedures per £1 million. Further information on the NHS’s national cost collection is available at the following link:https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/Prices for individual procedures are set out in the NHS Payment Scheme. How the procedures are delivered is a local decision, to reflect local population need and to allow for the greatest opportunity to deliver value for money in local budgets. The Department does not hold a national estimate by procedure of care delivered through insourcing or outsourcing. However, NHS guidance for both insourcing and outsourcing makes clear the expectation that services are contracted at or below the unit prices set out in the NHS Payment Scheme.

How revenues from the sale of NHS Property Services assets are re-allocated.

Where integrated care boards (ICBs) declare NHS Property Service (NHSPS) owned assets surplus to their future clinical requirements, the NHSPS markets these properties for sale with the net proceeds, after the cost of sale, being reinvested into operational healthcare facilities. All sales follow the process set out in Managing Public Money, to maximise value for the taxpayer.All net proceeds from the sale of surplus NHSPS assets are split equally between local and national capital investment projects, with half of the proceeds being invested in local priority capital investment schemes agreed with the local ICB, and the remainder being reinvested in NHSPS owned properties, to ensure that all NHSPS properties continue to meet statutory requirements. Running cost and rental savings associated with the rationalisation of the estate and the disposal of surplus sites accrue to the National Health Service. NHSPS is a not-for-profit company wholly owned by My Rt Hon. Friend, the Secretary of State for Health and Social Care.

What steps his Department is taking to improve cross communication between NHS organisations.

The Government is committed to harnessing technology and modernising the health system by shifting from analogue to digital, including through streamlined data sharing to improve communication across National Health Service organisations.Regulations have been introduced in Parliament to establish the process for preparing and publishing information standards which will be mandatory for public and private health and adult social care providers. Information standards allow for interoperability between systems, and for information to be shared easily between the systems in different organisations, to improve outcomes for patients.We have also announced the development of a single patient record which will give professionals in different services access to patient information they need to make the best-informed decisions when delivering care and treatment.

What steps he is taking to improve early diagnosis of pancreatic cancer.

The Government is committed to improving care pathways for all those with cancer, including pancreatic cancer. This threshold is key to improving outcomes and survival rates, including for people diagnosed with pancreatic cancer.Pancreatic cancer is difficult to diagnose due to its unspecific symptoms. The National Health Service is implementing non-specific symptom pathways for patients who present with vague and non-site-specific symptoms which do not clearly align to a tumour type. This includes symptoms of pancreatic cancer.NHS England is providing a route into pancreatic cancer surveillance for those at inherited high-risk to identify lesions before they develop into cancer. NHS England is additionally creating pathways to support faster referral routes for people with non-specific symptoms and is increasing direct access for general practitioners to diagnostic tests. We have submitted an expression of interest to be a part of the upcoming national case finding pilot, which aims to improve earlier diagnosis of pancreatic cancers.

With reference to the Stroke Association's report entitled Unlocking Potential: A Bold Vision for Stroke Care in England, what steps his Department is taking to (a) reduce disability and death from stroke, (b) improve access to stroke care in the community and (c) help tackle social inequalities in stroke outcomes.

The Stroke Association’s report, Unlocking Potential: A Bold Vision for Stroke Care in England, provides comprehensive plan to improve stroke care in England over the next decade highlighting several key areas for improvement, including prevention, digital innovation, and community support. These areas align with the Department's commitment to the 10-Year Health Plan’s three transformative shifts in healthcare: moving more care from hospitals into homes, prioritising prevention over treatment, and advancing from analogue to digital solutions. These strategic shifts are the building blocks to our health mission, namely reducing time spent in poor health, tackling health inequalities and reducing the lives lost from the biggest killers, which includes stroke.NHS England is prioritising implementation of the National Service Model for an Integrated Community Stroke Service (ICSS model) with delivery of specialist stroke rehabilitation at home and in care homes, as well as improving life after stroke support and six-month follow-up reviews by working closely with the voluntary sector. The ICSS model is vital to support physical, cognitive and psychological recovery, return to work and quality of life. More information on the model is available at the following link:https://www.england.nhs.uk/publication/national-service-model-for-an-integrated-community-stroke-service/The ICSS model includes provision of tailored and patient centred reablement care, through joint working between the National Health Service and social care. Provision of peer support and reviews every six months, information, and longer-term support in the community is also achieved through integrated and collaborative working with the voluntary sector.The National Stroke Quality Improvement in Rehabilitation (SQuIRe) programme is driving implementation of the integrated community stroke services model in England. NHS England funds SQuIRe posts in each NHS region to work with integrated care boards (ICBs) to improve provision of community-based stroke rehabilitation, promote recovery from stroke and improve patient outcomes. ICBs also receive a separate funding allocation to support prevention services which include stroke rehabilitation.

What progress has been made on research into a breath test to enable early detection of Pancreatic Cancer.

The PANACEA study will recruit 8,000 patients across 40 sites by September 2026 to evaluate breath test performance and is expected to complete in March 2027. This is one strand of the Office for Life Sciences’ Cancer Healthcare Goals Programme, which supports the development of technologies that enable earlier, more effective cancer diagnosis and improved treatment. The Department invests over £1.6 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR spent £133 million on cancer research in 2023/24.

Whether he plans to include measures to support palliative and end of life care in the 10 Year Health Plan.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and families receive the care they need when and where they need it, including those who need palliative and end of life care.As part of the work to develop a 10-Year Health Plan, we have been carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners, including the hospice sector.

What discussions he has had with the Chancellor of the Exchequer on the Transformation Fund announced in the Spring Statement 2025; and whether he has made an assessment of the potential merits of using some of this money for the palliative and end of life care sector.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift. In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.As part of the Spring Statement, Government announced a £3.25 billion Transformation Fund to drive efficiencies across government and save money later in the Parliament, and set out how this would be allocated over the Spending Review process.The Spending Review is underway, and details will be announced on 11 June 2025.

Whether the Comprehensive Spending Review will contain measures to (a) improve and (b) reform the current funding allocations for palliative and end of life care services.

We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift. In February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.As part of the Spring Statement, Government announced a £3.25 billion Transformation Fund to drive efficiencies across government and save money later in the Parliament, and set out how this would be allocated over the Spending Review process.The Spending Review is underway, and details will be announced on 11 June 2025.

What discussions he has had with Cabinet colleagues on providing long term, sustainable funding for transforming palliative and end of life care services.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has regular discussions with my Rt. Hon. Friend, the Chancellor of the Exchequer and colleagues across the Cabinet on a whole host of issues across our brief, including palliative and end of life care services.However, as part of the work to develop the 10-Year Health Plan, we will be carefully considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our partners.We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. The Government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative and end of life care services will have a big role to play in that shift.Additionally, in February, I met with key palliative and end of life care and hospice stakeholders, in a roundtable format with a focus on long-term sector sustainability within the context of our 10-Year Health Plan.