Written questions by Maguire.

What assessment he has made of the potential merits of providing specialist menopause training for at least one GP in every surgery.

General practitioners (GPs) are responsible for ensuring their own clinical knowledge, including on menopause, remains up-to-date and for identifying learning needs as part of their continuing professional development. This activity should include taking account of new research and developments in guidance, such as that produced by the National Institute for Health and Care Excellence, to ensure that they can continue to provide high quality care to all patients.All United Kingdom registered doctors are expected to meet the professional standards set out in the General Medical Council’s (GMC’s) Good Medical Practice. The training curriculum for postgraduate trainee doctors is set by the Royal College of General Practitioners, and must meet the standards set by the GMC.The GMC has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK. The content map for this assessment includes several topics relating to women’s health including menstrual problems, endometriosis, menopause and urinary incontinence. This will encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK.

What steps he is taking to ensure clearer support pathways for women experiencing the menopause.

The Government recognises that women suffering from symptoms of menopause have been failed for far too long, and we acknowledge the impact it has on women’s lives, relationships and participation in the workplace.The National Institute for Health and Care Excellence (NICE) published their updated guideline on 7 November 2024 and recommended more treatment choices for menopause symptoms.Women’s health hubs are an effective model for improving access to and experiences of care for women and include menopause as an essential service. That is why the hub in Tower Hamlets was included in the 10 Year Health Plan as a best practice example to guide the shift to neighbourhood health. As of March 2025, 41 of the 42 integrated care boards in England reported to NHS England that they had a women’s health hub.

What steps he is taking to improve career progression pathways for NHS nursing staff.

The Government has accepted 36 non-pay recommendations from workstreams committed to in the 2023 Agenda for Change (AfC) pay deal. Some of these recommendations include specific measures to improve career progression for nurses, such as reviewing Annex 20 of the AfC contract to ensure nurses are not inadvertently excluded from the development of professional roles and developing guidance to help employers support the career progression of ethnic minority and internationally educated nurses. Implementation of these measures will take place over the next two years.

What steps he is taking to ensure integrated care boards publish data on funding for children’s hospices.

Palliative care services, including for children, are included in the list of services that integrated care boards (ICBs) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.Whilst the majority of palliative 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’s hospices, also play in providing support to children who require palliative care and end of life care, and their loved ones.Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative care and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area. It is for ICBs to determine whether they publish their funding data.We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care. The allocations for 2024/25 are available at the following link:https://www.gov.uk/government/news/hospices-receive-multi-million-pound-boost-to-improve-facilitiesThe allocations for 2025/26 are available at the following link:https://www.gov.uk/government/news/75-million-boost-for-hospices-to-transform-end-of-life-careWe 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.In 2024/25 and 2025/26, this funding was administered via ICBs in line with NHS devolution.

What steps he is taking to ensure the consistent availability of menopause medications.

There are over 70 hormone replacement therapy (HRT) products, and the vast majority are in good supply. We are aware of supply issues affecting Estradot (estradiol) patches until early October 2025. We have issued comprehensive management guidance to healthcare professionals and Serious Shortage Protocols to enable community pharmacists to supply specified alternative estradiol patches, with the patient’s consent and without needing to seek authorisation from the prescriber. We work closely with suppliers and other stakeholders such as the National Health Service and the Medicines and Healthcare products Regulatory Agency to maintain overall HRT supply to patients across the United Kingdom during any shortages, including working to expedite resupply dates of the disrupted HRT products to resolve issues as soon as possible and to help fill supply gaps and prevent future shortages. We have added estradiol to the list of products that cannot be exported from, or hoarded in, the UK to protect supply of this hormone replacement therapy for UK patients.

What oversight mechanisms are in place to ensure that evidence submitted to the UK COVID-19 Inquiry from (a) bereaved families and (b) their legal representative is represented in (i) published materials and (ii) oral hearings.

The Covid-19 Inquiry is independent of the Government, and its timing, process and focus are all matters for the Chair, Baroness Heather Hallett. This includes the submission and representation of evidence.

If his Department will release all bereavement case studies submitted to Module 4 of the UK COVID-19 Inquiry in a timely manner.

The COVID-19 Inquiry is independent of the Government, and its timing, process, and focus are all matters for the Chair, Baroness Heather Hallett. This includes the disclosure of documents submitted to the Inquiry.

Whether his Department has made an estimate of the proportion of firearm holders with a firearms marker on their patient records.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensingTo support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

What assessment his Department has made of the potential impact of the tightening of eligibility criteria for NHS Continuing Healthcare by Integrated Care Boards on disabled people's ability to (a) access and (b) remain in employment.

The Department is responsible for Continuing Healthcare (CHC) policy and legislation. We have provided statutory guidance, setting out clear processes for CHC, which all integrated care boards (ICBs) must have regard to. CHC is funded by ICBs, and it is for individual ICBs to make assessments and decisions in a consistent manner in line with their statutory duties and guidance. This guidance has not changed and ICBs are expected to maintain CHC delivery in line with their statutory duties. NHS England holds ICBs accountable and engages with them to ensure that they discharge their functions. This includes monitoring eligibility rates and undertaking detailed work to compare ICBs with similar demographics, including further investigation of outliers for drivers of variation.

What information his Department holds on the percentage of GPs that have downloaded firearms marker software.

The role of general practitioners (GPs) in the firearms licensing process is set out in the Home Office’s publication Firearms licensing: statutory guidance for chief officers of police, which is available at the following link:https://www.gov.uk/government/publications/statutory-guidance-for-police-on-firearms-licensingTo support their role, a digital marker, SNOMED activity coding, was fully rolled out across GP IT suppliers by May 2023, giving all GPs in England access within existing GP IT systems. GPs do not need to download a separate firearms marker software.We have not made an estimate of the proportion of firearm holders with a firearms marker on their patient records. This is because NHS England publishes an annual SNOMED report, which includes information on the number of times a relevant firearms code was added to GP patient records within the publication period. The report is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/mi-snomed-code-usage-in-primary-care/2023-24It should be noted that a patient could have one code added to their record multiple times throughout the year, and therefore, it is not possible to infer the number of patients with a particular code from this data. We are exploring options for how this data can be analysed to support the use of the digital marker.This significant strengthening of the medical checks process aids GPs, or any other registered medical practitioners, in completing the application form for a person’s medical suitability for a firearms licence. The digital marker also alerts a GP if there is any concerning deterioration in a person’s health presented during the five year licence period that may impact their suitability to hold a firearms licence. GPs can now more easily alert their local police force when necessary, as the decision for who can grant and renew a firearms licence remains with the local police force.

What assessment he has made of the level of employment opportunities for newly qualified nurses in Surrey.

Decisions on the employment of newly qualified nurses are a matter for individual National Health Service trusts, which manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.As set out in the 10-Year Health Plan, we are working closely with NHS England, employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What steps his Department is taking to ensure that there is sufficient project delivery capacity within (a) the NHS and (b) supply chains to implement the New Hospital Programme.

Earlier this year, the New Hospital Programme (NHP) appointed a Health Delivery Partnership as its principal Programme Delivery Partner, which is working closely with the NHP to provide the expert technical skills needed to develop the infrastructure and programme delivery capability to support successful delivery.The NHP remains committed to strengthening its internal capacity, supported by a Knowledge and Skills Transfer Strategy aimed at embedding the self-sustaining knowledge and skills required to increase its in-house resource.Since 2021, the NHP has undertaken extensive market engagement with industry to build industry interest, assess current capacity, and understand key investment drivers. The NHP launched procurement for its bespoke Hospital 2.0 Alliance Framework, designed to establish a long-term, sustainable, and collaborative supply chain partnership and contracting model that will secure market appetite and investment.The NHP is currently engaging with industry on the Hospital 2.0 integrated system, particularly the technical requirements, specification, and designs. Three key industry sectors identified to focus on include: designers and architects; main works contactors; and mechanical, electrical, and plumbing contractors.

What steps his Department is taking to increase the accessibility of band five nursing roles available to newly qualified nurses with (a) less than two years' experience, (b) between two and four years' experience and (c) over four years' experience.

Decisions about recruitment are a matter for individual National Health Service employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.NHS England is working with employers, universities, and regional nursing leads to ensure support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.

What mechanisms are in place to ensure (a) local community and (b) patient engagement in the (i) design and (ii) delivery of new NHS hospital infrastructure.

Hospital 2.0 is the New Hospital Programme’s (NHP) approach to standardising the design for future hospitals and has been designed and developed with people with lived and learnt experiences throughout the stages of the design process, from strategic outline business cases, early plans to commissioning, and full operationalisation. Stakeholders include National Health Service staff, NHS trusts, royal colleges, patients, and the public, as well as the supply chain. Over 1,300 clinicians, over 400 patients and lived experience partners, and 57 architects and designers have worked alongside subject matter experts to feed into the design process. This is to ensure that new hospitals will meet current and future healthcare needs, and that patients and staff are at the heart of its designs. The NHP works collaboratively with NHS England and trusts to ensure that the design of each hospital is right-sized for local circumstances and tailored to the needs of the local community. The NHP is currently embarking on another cycle of formal engagement workshops with key national stakeholders to showcase the current progress of Hospital 2.0 designs, with a workshop focussed on the patient and public perspectives. Outside the NHP, the majority of investment in new hospital infrastructure relates to works on part of a site or to renovation and maintenance, and so is subject to local design considerations. When healthcare services are relocated to a new site a formal process of consultation is followed. At a local level, integrated care boards are responsible for strategic infrastructure planning, managing the budget, and allocating funding according to local priorities in their area. Local systems have also developed infrastructure strategies to create a long-term plan for future estate requirements and investment for each local area and its needs.

What steps he is taking to ensure newly qualified nurses have pathways to gain clinical experience.

NHS England is working with employers, universities, and regional nursing leads to ensure that support is in place to help graduating nurses find a role as soon as possible after qualification and transition into the workplace.It is important that as part of their first roles, newly registered nurses are supported to embed their skills and integrate into their new team and place of work. Nursing preceptorships provide structured support for newly qualified nurses to do this as they transition into professional roles. The NHS England National Preceptorship Framework sets out that all newly qualified nurses should receive preceptorship in their first-year post-registration.

Whether his Department has made an assessment of the potential impact of NICE’s rejection of trastuzumab deruxtecan for use in secondary breast cancer treatment on patient outcomes.

Decisions on whether new medicines should be routinely funded by the National Health Service in England are made on the basis of recommendations from the National Institute for Health and Care Excellence (NICE) following an evaluation of a treatment’s costs and benefits. These are very difficult decisions to make, and it is important that they are made independently and on the basis of the available evidence.NICE published guidance in July 2024 on the use of Enhertu for the treatment of HER-2 low metastatic and unresectable breast cancer and was unfortunately unable to recommend it for routine NHS funding. I understand that NICE and NHS England have sought to apply as much flexibility as they can in their considerations of Enhertu for HER2-low breast cancer and have made it clear to the companies that their pricing of the drug remains the only obstacle to access.Ministers met with the manufacturers of Enhertu, AstraZeneca and Daiichi Sankyo, in November 2024, to encourage them to re-engage in commercial discussions with NHS England. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price. NICE’s guidance published in July 2024 will therefore remain unchanged. NICE has reassured me that the door remains open for the companies to enter into a new NICE appraisal if they are willing to offer Enhertu at a cost-effective price.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible NHS patients.

What assessment his Department has made of the potential impact of NICE’s severity modifier on access to new treatments for incurable secondary breast cancer.

The National Institute for Health and Care Excellence (NICE) is responsible for the methods and processes that it uses in the development of its recommendations. The severity modifier was introduced in January 2022 as part of a number of changes intended to make NICE’s methods fairer, faster, and more consistent.NICE carried out a review of the implementation of the severity modifier in September 2024 and found that it is operating as intended. This showed that the proportion of positive cancer recommendations is higher, at 84.8%, than with the end-of-life modifier it replaced, at 75%, and the proportion of positive recommendations for advanced cancer treatments is also higher, at 81.1% compared to 69%.Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed. These treatments are now available to eligible National Health Service patients.NICE has commissioned research to gather further evidence on societal preferences that will inform future method reviews.

What assessment he has made of the adequacy of suicide prevention training provided to ambulance staff.

Looking after the mental health of hard-working NHS staff is essential, and particularly so for ambulance staff as responders to emergency incidents. Ambulance Trusts and the Association of Ambulance Chief Executives have worked closely with NHS England to ensure there is a good range of health and wellbeing support available for staff. This includes an ambulance sector specific suicide prevention pathway to provide immediate support 24/7 for staff experiencing suicidal ideation. At a national level, ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction.We have also announced in the 10-Year Health Plan that we will roll out Staff Treatment Hubs to provide a high-quality occupational health service for all NHS staff, including support for mental health issues and back conditions, with both being significant causes of long-term sickness absence.

What estimate his Department has made of the number of GPs expected to retire by 2030; and whether the NHS Long Term Workforce Plan accounts for shortages in (a) the South East and (b) other regions.

No estimate has been made of the number of general practitioners (GPs) expected to retire by 2030. A GP's decision to retire can be influenced by many factors. Therefore, we do not have the data to make forecasts.In May 2025, there were 691 more full time equivalent (FTE) GPs than in May 2024. Workforce shortages are greater in some, particularly deprived, areas.In August 2024, we announced an £82 million in-year funding boost to allow recently qualified GPs to be hired through the Additional Roles Reimbursement Scheme, and have so far recruited over 1,900 GPs, exceeding our target of 1,000.Through a 3% real terms growth in funding for the NHS over three years, we will train thousands more GPs and deliver millions more appointments.We will publish a 10-Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible and more fulfilled.The 10-Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.

Whether his Department has made an assessment of the merits of (a) incentivising GPs nearing retirement to remain in the profession and (b) incentivising retired GPs to return to practice.

We will publish a 10 Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible and more fulfilled.The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.From now on, we will ensure that staff will be better treated, have better training, more fulfilling roles, and hope for the future, so they can achieve more.