Written questions by Maguire.

What the target HPV vaccination rate for Epsom and Ewell constituency was in (a) 2023-24 and (b) 2024-25; what the actual vaccination rate was in those periods; and whether his Department plans to reach the World Health Organization vaccination target rate.

Human papillomavirus (HPV) vaccine coverage is presented for England at national, National Health Service commissioning region, and local authority levels. Data is not gathered at constituency level. Vaccine coverage data for the routine school-aged HPV immunisation programme in England, including for the 2023 to 2024 academic year, is available at the following link:https://www.gov.uk/government/collections/vaccine-uptake#hpv-vaccine-uptakePlease refer to the supporting tables for local level uptake data.Given the global public health burden of cervical cancer caused by HPV, the World Health Assembly adopted the Global strategy to accelerate the elimination of cervical cancer as a public health problem, with a target of 90% of girls being fully vaccinated with the HPV vaccine by 15 years old. This target focuses on the coverage of girls only. Further information on the strategy to accelerate the elimination of cervical cancer is available at the following link:https://www.who.int/publications/i/item/9789240014107In March 2025, NHS England published the Cervical cancer elimination plan by 2040 – for England, which outlines how the NHS will improve uptake and coverage across HPV vaccination and cervical screening. Further information on the Cervical cancer elimination plan by 2040 – for England is available at the following link:https://www.england.nhs.uk/publication/cervical-cancer-elimination-by-2040-plan-for-england/

What steps his Department is taking to help reduce delays in adult social care assessments for hospital discharge.

The Urgent and Emergency Care plan for 2025/26, published by NHS England, has set a priority that hospitals should tackle the delays in patients waiting to be discharged. The plan asks systems to set local performance targets by discharge pathway and eliminate internal discharge delays of more than 48 hours in all settings.For 2025/26, £9 billion is available through the Better Care Fund to provide services, including those which help reduce delayed discharges. All health and wellbeing boards are required to set goals to reduce discharge delays, which will be used to monitor performance and drive accountability throughout 2025/26.

What the current NHS dentist vacancy rate is in Surrey; and what steps he is taking to ensure equitable dental care access in Epsom and Ewell constituency.

In 2024, there was a 20% vacancy rate for NHS dentists in the Surrey Heartlands Integrated Care Board (ICB), which includes the Epsom and Ewell constituency. We do not hold data at constituency level. More data is available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/dental-workforce/The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to ICBs across England. For the Epsom and Ewell constituency, this is Surrey Heartlands ICB.We will deliver 700,000 extra urgent dental appointments per year, and ICBs have been making extra appointments available from 1 April 2025. Surrey Heartlands ICB is expected to deliver 6,585 additional urgent dental appointments as part of the scheme.The Government’s ambition is to deliver fundamental contract reform before the end of this Parliament.

What steps he is taking to help GPs who are unable to find employment despite workforce shortages.

The Government has invested £82 million in the Additional Roles Reimbursement Scheme (ARRS), which has enabled the recruitment of more than 1,900 recently qualified general practitioners (GPs) in England since October. 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.Under recently announced changes to the GP Contract in 2025/26, the ARRS will become more flexible to allow primary care networks to respond better to local workforce needs. The two ARRS pots have been combined to create a single pot for reimbursement of patient-facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.On 27 February, the Government and the British Medical Association agreed to the changes to the GP Contract to fix the front door of the National Health Service, and to bring back the family doctor. We are investing an additional £889 million in GPs for 2025/26, bringing total spending on the GP Contract to £13.2 billion. This is the largest uplift to GP funding since the beginning of the five-year framework, and means we are reversing recent trends by allocating a rising share of NHS resources to GPs.

What assessment his Department has made of the adequacy of core funding for general practice.

We have invested an additional £889 million in general practice (GP) 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.The changes to the contract will improve services for patients and make progress towards the Government’s Health Mission, supporting the three key shifts the Government wants to achieve, from analogue to digital, from sickness to prevention, and from hospital to community care.GP providers are valued independent contractors. Every year we consult with the sector both about what services they provide, and the money providers are entitled to in return under their contract. Operating costs for these providers are taken into account as a part of this process.

What assessment his Department has made of the potential impact of Integrated Care Board funding levels on GP recruitment and retention in Epsom and Ewell constituency.

We are investing an additional £889 million in GPs for 2025/26, bringing total spending on the GP Contract to £13.2 billion. This is the largest uplift to GP funding since the beginning of the five-year framework, and means we are reversing recent trends by allocating a rising share of National Health Service resources to GPs.Under recently announced changes to the GP Contract in 2025/26, the Additional Roles Reimbursement Scheme (ARRS) will become more flexible to allow primary care networks to respond better to local workforce needs. The two ARRS pots have been combined to create a single pot for the reimbursement of patient-facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.In the Epsom and Ewell constituency, as of 31 May 2025, there were 67.8 full time equivalent doctors in GPs, and since October 2024, 1,900 GPs have been recruited via the ARRS nationally.

Pursuant to the Answer of 4 April 2024 to Question 19410 on General Practitioners: Labour Turnover, what estimate he has made of the number of GPs on ICB funded training schemes which are equivalent to the (a) General Practice Fellowship and (b) Supporting Mentors schemes.

Data on integrated care board (ICB) funded training schemes, their equivalent to the General Practice Fellowship scheme and the Supporting Mentors scheme, or the numbers of staff benefitting from these schemes is not held centrally.While NHS England provides funding, through ICB allocations and the Primary Care Transformation Fund, to develop general practice services and teams, ICBs have the autonomy and flexibility to make decisions that serve the best interests of local people and communities.

What steps his Department is taking to ensure that primary care services are adequately resourced in Surrey.

Every year we consult with each primary care profession about what services they will provide, and the funding providers are entitled to in return under their contracts.Integrated care boards (ICBs) are responsible for commissioning primary care services within their regions. This includes ensuring service providers are able to meet the reasonable needs of their patient population. Where necessary, ICBs can commission local enhanced services which can vary in scope and funding, to fit the needs of the patient population.

What assessment he has made of the adequacy of funding for the new hospital in Sutton, in the context of rising construction and building costs.

We have now put the New Hospital Programme on a sustainable footing, with a timeline that can be met, and a budget that is consistent with the fiscal rules under which the Government is operating. We are backing this plan with investment, which will increase to up to £15 billion over each consecutive five-year wave, averaging approximately £3 billion a year from 2030. The exact profile of funding will be confirmed in rolling five-year waves at regular Spending Reviews, as with all Government capital budgets in future. The cost estimates for schemes include the significant cost of inflation in recent years and use a construction specific index to inflate future costs.The final funding amount for the Specialist and Emergency Care Hospital in Sutton will be subject to the review and approval of a Full Business Case nearer to construction starting between 2032 and 2034, as is standard for large infrastructure projects.

When his Department plans to announce the (a) personnel requirements and (b) organisational design for (i) Op Courage and (ii) Op Restore.

Op RESTORE and Op COURAGE are established bespoke National Health Service commissioned services for veterans. There are currently no plans for announcements to be made about personnel requirements and organisational design for Op COURAGE and Op RESTORE.The new joint centre will take forward the Government’s ambitious reform agenda as set out in the Health Mission and Plan for Change, with more details to come when the 10-Year Health Plan is published.

Whether his Department has made an assessment of the potential impact of community care staffing levels on hospital bed occupancy levels in Surrey.

No specific assessment has been made. Integrated care board are responsible for commissioning services to meet the needs of their local communities, including in Surrey, as they are best placed to take those decisions.The Government is committed to building a health service fit for the future. We will shortly publish a 10-Year Health Plan which will set out the radical reforms needed to make the National Health Service fit for the future. This will include a focus on shifting care from the hospital to the community, to bring care closer to where people live.

What the average delay is between patient (a) referral and (b) diagnostic testing in Epsom and St Helier University Hospitals NHS Trust; and what steps he is taking to reduce diagnostic waiting times.

There is no complete measure for the average wait time for a patient between a referral and receiving a diagnostic test for all diagnostic tests.The Diagnostic Waiting Times and Activity monthly collection, known as DM01, measures the current waiting times of patients still waiting for 15 key diagnostic tests or procedures at the end of each month. As of the end of March 2025, of those that were on the waiting list for a key diagnostic test at the Epsom and St Helier University Hospitals NHS Trust, the median average length of time patients had been waiting was 2.5 weeks, compared to 2.7 weeks nationally. Details on this collection are available at the following link:https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/Cutting waiting lists, including for diagnostic tests, is a key priority for the Government. Our Elective Reform Plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres, and better use of technology.

What assessment he has made of the potential impact of using private partnerships to build NHS hospitals on public finances.

There has been no formal assessment on the potential impact of using private partnerships to build National Health Service hospitals. Current HM Treasury policy is that private finance cannot be used. As part of the NHS capital strategy, we are considering how best to address capital funding issues in the NHS estate, and all investments will be subject to value for money and strategic assessments.

How many referrals there have been to (a) Operation Courage and (b) Operation Restore in each year since 2016; and how many of those referrals were reviewed by multi-disciplinary teams within 8 weeks.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

Who Operation (a) Courage and (b) Restore will be (i) managed and (ii) funded by after the abolition of NHS England.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

What the allocated budget was for (a) Operation Courage and (b) Operation Restore in each financial year between 2020-21 and 2024-25; and how much funding has been allocated to each programme in the 2025-26 financial year.

On 13 March 2025, it was announced that NHS England will be brought into the Department to form a new joint centre. We are assessing the full range of current functions across both organisations and options for future allocation. At this stage, it is too early to say what precise changes in personnel and organisational design will be. The following table shows the actual spend on Op COURAGE and Op RESTORE for 2020/21 to 2024/25 and the budget for 2025/26:Financial YearOp COURAGE (£ mil)OP RESTORE (£ mil)2020/2117.90.32021/2218.50.22022/2323.00.62023/2423.80.52024/2524.40.92025/2624.90.9Source: NHS EnglandThe following tables show the referral numbers for Op COURAGE and Op RESTORE since 2017/18 and 2018/19, respectively, as well as the percentage of referrals for Op COURAGE met within relevant targets since 2023/24 and for Op RESTORE since 2021/22:Financial YearReferrals to Op COURAGE% of urgent referrals assessed within one week% of routine referrals assessed within 2 weeks2017/182879--2018/194561--2019/205374--2020/214903--2021/225970--2022/236272--2023/2468177549.52024/2572517644.3Source: NHS England Financial YearReferrals to Op RESTORE% assessed by multi-disciplinary team within 8 weeks2018/1950-2019/2050-2020/2141-2021/221491002022/2326598.42023/2437199.72024/2535097.7Source: NHS England

What steps his Department is taking to improve NHS staff (a) working conditions and (b) wellbeing.

The Government inherited a broken National Health Service with an overworked and demoralised workforce.We hugely value all NHS staff and are committed to improving working conditions, so we can keep staff healthy, motivated, and retain valuable skills. That is why one of our first actions was to give NHS staff an above inflation pay rise.Local employers across the NHS have in place arrangements for supporting staff, including occupational health provision, employee support programmes, and a focus on healthy working environments. At a national level, NHS England has made available additional emotional and psychological health and wellbeing support. They have also set out a roadmap for the NHS and partner organisations to work together to develop and invest in occupational health and wellbeing services for NHS staff.

What are the retention rates for NHS staff for each year since 2020.

NHS England publishes quarterly information on the turnover of National Health Service staff within their NHS Workforce Statistics publication, with further information available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statisticsThis covers the rate of staff joining and leaving active service in English NHS trusts and other core organisations over annual periods. Rates include staff going on, or returning from, periods of unpaid leave, such as career and maternity breaks, and will also include staff remaining in their professions but undertaking roles in other sectors such as primary care, social care, or independent provision. This data is available at national and regional levels, as well as for individual staffing groups. The latest release, which covers the year to December 2024, can be found at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/december-2024The Government is committed to making the NHS the best place to work, to ensure we retain more of our skilled and dedicated staff. NHS England is leading work nationally through its retention programme to drive a consistent, system-wide approach to staff retention across NHS trusts. This ensures trusts have access to proven retention strategies, data-driven monitoring, and can foster a more stable, engaged, productive, and supported workforce.

With reference to the publication entitled Working together in 2025/26 to lay the foundations for reform, published on 1 April 2025, if he will extend the time in which ICBs have to respond to the Model ICB once it is published.

Integrated care boards (ICBs) have a critical role to play as strategic commissioners, improving population health, reducing inequalities, and ensuring access to high quality care. NHS England has circulated a draft of The Model ICB - blueprint document to all ICBs, to assist them in shaping their future plans, including which functions they should focus on, as indicated in Sir James Mackey’s letter to the National Health Service trusts, foundation trusts, and ICBs, which is available at the following link:https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/#:~:text=When%20we%20met%20on%2013,the%20last%20few%20tricky%20weeks.We expect ICBs to adhere to the timelines set out by NHS England on 1 April 2025, to ensure that ICBs are acting as lead strategic commissioners of health and care services and to ensure that cost savings are directed to frontline NHS health and care services.

How much of the Claimant’s costs paid by the NHS in all clinical negligence claims under £25,000 in 2023-24 were (a) legal costs, (b) disbursements and (c) VAT.

NHS Resolution (NHSR) manages clinical negligence and other claims against the national Health Service in England. The following table shows the total legal costs paid for claimants due to clinical negligence claims closed in the financial year 2023/24, where damages were paid up to £25,000:Damages trancheClaimant legal costs paid by NHSR£1 to £1,500£2,422,432£1,501 to £25,000£94,364,395Total£96,786,827Claims closed in 2023/24 will often have been settled in previous years, as costs can take some time to finalise after an agreement on damages. NHSR does not record a breakdown of claimant legal costs between profit costs and disbursements in its claims management system. It also does not record a breakdown for expert fees.