Written questions by McMurdock.

What steps he is taking to improve communication around delays in appointment wait times for people seeking access to mental health support services.

Long waits for mental health services are being driven by increasing demand to a system in desperate need of change. The Government is already responding by delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres to bring together community, crisis and inpatient care. These operate 24 hours a day, seven days a week.NHS England Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity. We are also improving data quality so we can support providers to understand demand across their areas.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 an additional 8,500 staff across children and adult mental health services.

What recent assessment he has made of trends in the level of average wait times for people being referred for appointments for mental health support.

Long waits for mental health services are being driven by increasing demand to a system in desperate need of change. The Government is already responding by delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres to bring together community, crisis and inpatient care. These operate 24 hours a day, seven days a week.NHS England Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity. We are also improving data quality so we can support providers to understand demand across their areas.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 an additional 8,500 staff across children and adult mental health services.

What steps he is taking to improve (a) early diagnosis and (b) prevention strategies for chronic kidney disease in primary care settings.

NHS England’s Renal Service Transformation Programme (RSTP) highlighted the importance of prevention and of optimising screening, detection, and treatment. Regional NHS England Renal Networks are working in partnership with integrated care systems to deliver the RSTP’s aims, and to help develop effective strategies for their local populations.NHS England recognises the importance of kidney disease, not only in preventing the progression of kidney disease but also in reducing cardiovascular events. A customer relationship management steering group has been established which aims to focus on the prevention of these common condition that often co-exist.NHS England has expanded the scope of the work under the Prevention and Long-Term Condition Programme Board to include consideration of opportunities for improving the prevention of kidney disease.The NHS Health Check programme is a core component of England’s cardiovascular disease (CVD) prevention programme, which aims to prevent heart disease, stroke, diabetes, kidney disease, and some cases of dementia. The programme assesses for high blood pressure and high blood sugar, which are risk factors for the development of both chronic kidney disease and CVD. Where an individual’s NHS Health Check indicates high blood pressure or high blood sugar, it is for the general practitioner to consider the results, and then, if required, undertake further clinical investigation and treatment where appropriate.Diabetes is a leading cause of kidney disease. People at risk of developing type 2 diabetes can also be referred by their general practitioner into the Healthier You NHS Diabetes Prevention Programme. The programme is highly effective, cutting the risk of developing type 2 diabetes by 37% for people completing the programme, compared to those who do not attend.

Whether he plans to (a) support and (b) expand community-based physical activity programmes specifically designed for older people.

The Government and the National Health Service recognise that prevention will always be better and cheaper than a cure. Reducing physical inactivity in people of all ages, including in older people, is important in helping people live longer, healthier lives, and a key part of the Department’s shift from treatment to prevention.The Department supports the NHS, together with local authorities, to provide a range of community services to support older people, such as exercise on referral and social prescribing, aquatic/swimming classes, dance classes, and fall prevention training through strength and balance classes. The Government continues to encourage local authorities to invest in and prioritise leisure facilities and community-based services.In addition to the above, the NHS Better Health Campaign promotes ways for people of all ages to move more, and signposts to digital support like the NHS Active 10 walking app, an accessible way of building movement into everyday life.

What steps he is taking to ensure that NHS services are responsive to the (a) complex and (b) long-term needs of people living with chronic kidney disease.

NHS England has established a renal Clinical Reference Group to deliver change across the National Health Service, to accelerate improvements in the diagnosis of, and treatment for, people living with kidney disease.Increasing access to home therapies for kidney issues is a priority for NHS England, and this is reflected in its inclusion in the Renal Transformation toolkit, published in 2023. This recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.NHS England is improving access to home dialysis for children, supported by a robust network of nurses and clinicians who can move care from hospitals to homes. This approach is working, with rates of home dialysis ranging from 64% to 76% across the 10 NHS paediatric dialysis centres.

What steps he is taking to improve access to local NHS services for older people.

Integrated care boards (ICBs) are responsible for commissioning healthcare services that meet the needs of their local populations. When ICBs exercise their functions, they have a duty to reduce inequalities between persons with respect to their ability to access health services and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.Further, as part of the Government’s five long-term missions, we have launched a 10-Year Health Plan to reform the National Health Service and make it fit for the future.The 10-Year Health Plan will deliver the three big shifts our NHS needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving support for older people in all parts of the country.More care and support delivered in the community, better joint working between services, and greater use of apps and wearable technology will all support patients closer to home.The 10-Year Health Plan will also set the vision for what good joined-up care looks like for people with a combination of health and care needs, such as older people.  It will set out how to support and enable health and social care services, and wider services, to work together better to provide that joined-up care.

What steps his Department is taking to increase awareness of preventable complications associated with diabetes.

In England, the National Institute for Health and Care Excellence (NICE) recommends that people with diabetes are offered eight annual care processes in primary care, those being measurement of HbA1c, lipids, creatinine, albuminuria, blood pressure and body mass index, ascertainment of smoking status, and examination of the feet, to assess modifiable risk factors and facilitate the early identification of diabetic complications.These annual diabetes reviews are associated with reduced emergency admissions, amputations, retinopathy, and mortality.

What steps his Department is taking to help tackle the causes of diabetes.

The Department is actively tackling the root causes of type 2 diabetes. We are restricting junk food advertising on television and online, limiting school children's access to fast food, and are taking steps to ensure the Soft Drinks Industry Levy remains effective and fit-for-purpose.Through programmes such as the Healthier You NHS Diabetes Prevention Programme we are supporting individuals aged 18 to 80 years old to reduce their risk of developing type 2 diabetes through behavioural changes. As of December 2024, over 2.3 million people have been offered support through the programme, and an independent evaluation showed a 37% relative reduction in diabetes risk in those who completed the programme.Additionally, the Department’s Better Health resources include free evidence-based apps, websites, and other digital tools, to support people to make and sustain changes to their health and reduce their risk of developing type 2 diabetes, including the NHS Weight Loss app, the Food Scanner App, Couch to 5K, and Active 10. Type 1 diabetes cannot be prevented, and the exact causes of it are unknown.

What steps his Department is taking to ensure that GP websites using third party contractors for online appointment booking forms uphold patient privacy and security in data sharing.

All organisations that have access to National Health Service patient data must use the Data Security and Protection Toolkit to provide assurance that they are practising good data security and that personal information is handled correctly. The toolkit is available at the following link:https://www.dsptoolkit.nhs.uk/Third party organisations that use an IT system to make general practitioner appointments for patients must use a system which has been assured by NHS England, for example, through the usage of a Supplier Conformance Assessment List and clinical testing of the system before it is given permission to move to live usage. These checks help us to assure that patient data is managed within General Data Protection Regulation and that systems meet NHS security standards.There are strong protections in law to ensure that health and care information is used in a safe, secure and legal way. The privacy and confidentiality of people’s health and care data is championed by the National Data Guardian who provides independent advice on the use of such data and holds the Caldicott Principles which provide a framework for the safe and respectful use of data. In addition, every health and care organisation is required to appoint a Caldicott Guardian from within their organisation to advise on the protection of people’s health and care data and ensure it is used properly.

What discussions he has had with representatives of healthcare professions on levels of unmet equipment needs for children with disabilities.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

What steps she is taking to ensure families with disabled children have timely access to medical equipment.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

If he will make an estimate of the number of disabled children who do not have the equipment they need.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, meets regularly with external sector partners on a variety of issues.Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local population, including for disability equipment. Each ICB must have an executive lead for children and young people with special education needs and disabilities (SEND), who will support the board to perform its functions effectively in the interests of children and young people with SEND.We expect ICBs to follow guidance from the National Institute for Health and Care Excellence (NICE). In 2022, the NICE published the guidance, Disabled children and young people up to 25 with severe complex needs: integrated service delivery and organisation across health, social care and education, which is available at the following link:https://www.nice.org.uk/guidance/ng213/chapter/Recommendations-on-service-organisation-integration-and-commissioningLocal authorities are responsible for providing social care services for disabled children, which can include specialist equipment. The guidance on supporting disabled children and their carers can be found at the following link:https://assets.publishing.service.gov.uk/media/669e7501ab418ab055592a7b/Working_together_to_safeguard_children_2023.pdfSince July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required. NHS England is taking several steps to reduce regional variation in the quality and provision of National Health Service wheelchairs, and to support ICBs to reduce delays in people receiving wheelchair equipment. Data on the length of time taken to provide other equipment for disabled children is not collected centrally.

If he will ensure that pharmacies can access high-cost, short shelf-life medications rapidly.

In the United Kingdom, community pharmacies are private businesses which provide National Health Services, and therefore, for the majority of medicines which they supply in accordance with a prescription, they have their own buying arrangements. Not all manufacturers supply to all wholesalers and not all pharmacies use the same wholesalers, so there may be some specific manufacturer’s products that a pharmacy may not easily be able to source.Professional guidance advises that where a pharmacy is unable to supply a medicine promptly, if they have established there is not a shortage, then they should talk to the patient to discuss the possible options available to them. These can include:offering to contact the patient’s prescriber to jointly consider whether another suitable brand or medicine is available; andchecking whether the medicine is available at another pharmacy.

What steps his Department is taking to ensure patients can collect prescriptions in a timely manner (a) on bank holidays, (b) on weekends and (c) in general.

Local authorities are required to undertake pharmaceutical needs assessment (PNA) every three years to assess whether their population is adequately served by local pharmacies. Access to community pharmacies during weekdays, evenings, and the weekend is considered as part of these assessments. If a PNA identifies any gaps in the provision of essential services either within or outside normal working hours, or a need for improvement or better access, contractors can apply to meet this need.Integrated care boards (ICBs), as the commissioners of primary care services, give regard to PNAs when commissioning and planning local service provision. ICBs have various tools at their disposal to ensure patients can access medicines through local pharmacies, including commissioning extended pharmacy opening hours and maintaining a rota, directing and funding local pharmacies to open during bank holidays.Patients can also choose to access medicines and pharmacy services through any of the over 400 National Health Service online pharmacies that are contractually required to deliver prescription medicines free of charge to patients’ homes.

How many patients with valid NHS prescriptions for (a) molnupiravir and (b) similar antivirals were unable to obtain their medication within the recommended treatment window in the last 12 months.

The Department does not have information about the date of the onset of patient symptoms, which is the start of the five-day treatment window. The service level from the distributor in the last 12 months was 99.2% for molnupiravir and paxlovid, another COVID-19 antiviral, with the standard delivery being either the same day or the day after, in more remote locations.

If his Department will conduct a review into the (a) supply chain and (b) distribution of prescription medication to pharmacies in England.

Medicine supply chains are complex, global, and highly regulated and there are a number of reasons why supply can be disrupted, many of which are not specific to the United Kingdom and outside of Government control, including manufacturing difficulties, access to raw materials, sudden demand spikes or distribution issues, and regulatory issues. We have drawn on up-to-date intelligence and data on the root causes of medicine supply issues, with manufacturing problems being the most dominant root cause.The resilience of UK supply chains is a key priority, and we are continually learning and seeking to improve the way we work to both manage and help prevent supply issues and avoid shortages. The Department, working closely with NHS England, is taking forward a range of actions to improve our ability to mitigate and manage shortages and strengthen our resilience. As part of that work, we continue to engage with industry, the Medicines and Healthcare products Regulatory Agency, and other colleagues across the supply chain as we progress work to co-design and deliver solutions. We have plans underway to increase the awareness of our work. Given that there is a large amount of work already underway to ensure supply chain resilience, there are no current plans to conduct a new supply chain review.

What assessment he has made of the efficiency of the (a) storage, (b) procurement and (c) emergency dispensing of antiviral medications for high-risk patients.

Medicines, including antivirals, are stored in accordance with Good Distribution Practice, which is regulated by the Medicines and Healthcare Products Regulatory Agency. These will typically be held by medicine wholesalers who sell them on to community pharmacies and hospital pharmacies. Individual pharmacies will have their own procurement strategies. They should plan and manage stocks in line with demand, in order to ensure medicines are available to patients when needed.

What steps he is taking to help support improvement in domiciliary care providers that have been issued with warning notices by the Care Quality Commission.

To ensure adult social care providers, including domiciliary care services, meet fundamental standards of quality and safety, the Care Quality Commission (CQC) monitors, inspects, and regulates these services. All inspection reports on individual providers are made publicly available.The CQC is continuing to make changes to the way it works and has set out four immediate actions and five foundational improvements, which are being implemented to help ensure that it is carrying out its regulatory work with the sufficient depth and frequency to be assured that the requirements of any warning notices are met as close to the required compliance date as possible. These priorities will also enable the CQC to address delays in the reporting on the quality and safety of care in all care services, including domiciliary care services, which will increase transparency for both providers and the public who use these services.The CQC also signposts providers to the support that is available to help them improve, where shortfalls and breaches of regulation have been found. For example, Skills for Care have produced a Guide to Improvement to support providers that need to improve their rating.

What steps he is taking to improve transparency around (i) care quality and (ii) safeguarding in domiciliary care services.

To ensure adult social care providers, including domiciliary care services, meet fundamental standards of quality and safety, the Care Quality Commission (CQC) monitors, inspects, and regulates these services. All inspection reports on individual providers are made publicly available.Dr Penny Dash undertook a review of the CQC’s operational effectiveness in 2024, during which she uncovered significant concerns about the CQC’s internal operation. In response, the CQC is taking immediate action to help ensure that it is carrying out its regulatory work with sufficient depth and frequency. This will enable the CQC to address delays in the reporting on the quality and safety of care in all care services, including domiciliary care services, increasing transparency for both providers and the public who use these services. I met with Sir Julian Hartley on 14 March 2025, where we discussed the CQC’s recent challenges, and how we will continue working closely together on key priorities.Additionally, under the Care Act 2014, local authorities have statutory duties relating to safeguarding adults. Local Safeguarding Adults Boards help to provide transparency through a requirement that they carry out a Safeguarding Adult Review when an adult with care and support needs has died or has experienced serious abuse or neglect. The Department commissioned a national analysis of all such reviews that took place between 2019 and 2023. This work is published and serves to identify priorities for improvement, and is available at the following link: https://www.local.gov.uk/publications/second-national-analysis-safeguarding-adult-reviews-april-2019-march-2023-executive#conclusions-and-improvement-priorities

Whether she is taking steps to increase oversight of recruitment practices in domiciliary care agencies.

Most domiciliary care agencies are private sector providers and therefore their recruitment practises are independent of central Government.The Department works closely with regulators, local authorities, other Government departments, and enforcement bodies to share concerns and intelligence about, and where appropriate take action against, illegal or unethical recruitment practices in adult social care.Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 states that providers registered with the Care Quality Commission (CQC) must deploy “sufficient numbers of suitably qualified, competent, skilled and experienced staff to enable them to meet the needs of the people using the service at all times”. Additionally, Regulation 19 compels providers regulated by the CQC to make sure that they only employ “fit and proper” staff who are able to provide care and treatment appropriate to their role. To meet this regulation, providers must operate robust recruitment procedures, including undertaking any relevant checks.