Written questions by Naish.

Whether funding will be ringfenced for independent patient advocacy and engagement services at local level after the proposed abolition of local Healthwatch.

Funding for independent patient advocacy and funding for local Healthwatch is currently not ring-fenced, and the Department has no plans to introduce a ring fence in future years.The abolition of local Healthwatch arrangements, and transfer of their functions to integrated care boards for health, and local authorities for social care, will require primary legislation. The timing of this is subject to the will of Parliament and will happen when Parliamentary time allows.Funding considerations will be undertaken after legislation has received parliamentary approval.

If his Department will ensure that people with (a) severe multiple disadvantage and (b) other rare conditions are included in the (i) design and (ii) delivery of services after the proposed abolition of local Healthwatch organisations.

Dr Dash’s report on patient safety across the health and care landscape was published in July 2025. The review recommends bringing together the work of local Healthwatch organisations with the engagement functions of integrated care boards and providers to ensure patient and wider community input into the planning and design of services.These changes will improve quality, including safety, by making it clear where responsibility and accountability sit at all levels of the system. The changes will make it easier for staff, patients and service users, including those with severe multiple disadvantage and other rare conditions, to feed directly into the system to improve quality of care. We believe that patients and users will have a stronger voice once it is heard inside the system.

What steps he will take to ensure that patients have access to independent statutory mechanisms for raising concerns about health and care services following the proposed abolition of local Healthwatch organisations.

The report by Dr Penny Dash, published in July, recommended bringing together the work of local Healthwatch organisations, and the engagement functions of integrated care boards (ICBs) and providers, to ensure patient and wider community input into the planning and design of services. The recommendations in the report were accepted, in full, by the Government. The abolition of local Healthwatch arrangements, and the transfer of their functions to ICBs and local authorities will require primary legislation. The timing of this is subject to the will of Parliament and will happen when Parliamentary time allows.

When NICE last reviewed its guidance on the (a) availability and (b) prescribing of T3 for the treatment of thyroid cancer; and whether he has plans to improve access to T3 for patients where it is clinically indicated.

The National Institute for Health and Care Excellence (NICE) has not made any recommendations on the use of liothyronine in the treatment of thyroid cancer. NICE published a guideline on the assessment and management of thyroid cancer in December 2022. There are currently no plans to review the guideline.NHS England produced advice for prescribers on the use of liothyronine, otherwise known as T3, in August 2023 that sets out details on those patients that may benefit from T3 and how prescribers can prescribe this medicine to those patients. It recommends liothyronine as part of the management of thyroid cancer in preparation for radioiodine remnant ablation and radioiodine therapy. The advice is available at the following link:https://www.england.nhs.uk/long-read/liothyronine-advice-for-prescribers/We are aware that liothyronine 20 microgram vials will be out of stock from October 2025 until the end of April 2026. NHS England will be issuing national communications containing advice during the period of disruption to supply of the licensed product, outlining the availability of unlicensed imports and other clinical alternatives. NHS England is not aware of any supply issues affecting oral presentations of liothyronine.

Whether her Department has made an assessment of the potential merits of extending the job guarantee scheme for newly qualified nurses and midwives to include (a) occupational therapists, (b) physiotherapists and (c) other allied health professionals.

There are no plans to expand the job guarantee scheme to the professions highlighted, but the Government is committed to supporting all clinical staff in their careers. The new 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it.

What steps his Department is taking to help tackle air pollution.

Air pollution is one of the greatest environmental harms to public health. Our 10-Year Health Plan (10YHP) for England sets out how the Government plans to improve the health of the nation, including a focus on prevention of ill health. The plan sets out cross-Government action to tackle air pollution. This includes a review of the Environmental Improvement Plan, which will set out measures to reduce emissions and everyone’s exposure to air pollution.

What steps his Department is taking to support unplanned specialist social care services that help prevent hospital admissions for people with complex needs.

The Government and the National Health Service are working with local authorities and adult social care providers to help keep people well and independent for as long as possible, and to provide alternatives to hospital and care home admissions.We have set out priorities for the NHS and local authorities to begin to move to a neighbourhood health service that delivers more care closer to home and that better supports people with complex needs. We are asking local systems to systematically implement six core components of neighbourhood health, which will help people stay healthy and independent for longer and reduce unnecessary time spent in hospital. This includes integrated intermediate care services to prevent an avoidable hospital admission or as part of hospital discharge planning.NHS Operational Planning Guidance for 2025/26 sets an objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people. There is funding in NHS integrated care board baselines this financial year to improve community support provision and reduce reliance on inpatient care for people with a learning disability and autistic people, in line with the NHS Operational Planning Guidance.The Mental Health Bill was introduced in the House of Lords on 6 November 2024. Through our proposed reforms to the Mental Health Act, we want to ensure that people with a learning disability and autistic people get the support they need in the community, improve care, and prevent admission to hospitals.

What assessment his Department has made of the role of short-term, unplanned adult social care services in preventing hospital admissions for working-aged adults with (a) learning disabilities and (b) complex needs.

The Government and the National Health Service are working with local authorities and adult social care providers to help keep people well and independent for as long as possible, and to provide alternatives to hospital and care home admissions.We have set out priorities for the NHS and local authorities to begin to move to a neighbourhood health service that delivers more care closer to home and that better supports people with complex needs. We are asking local systems to systematically implement six core components of neighbourhood health, which will help people stay healthy and independent for longer and reduce unnecessary time spent in hospital. This includes integrated intermediate care services to prevent an avoidable hospital admission or as part of hospital discharge planning.NHS Operational Planning Guidance for 2025/26 sets an objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people. There is funding in NHS integrated care board baselines this financial year to improve community support provision and reduce reliance on inpatient care for people with a learning disability and autistic people, in line with the NHS Operational Planning Guidance.The Mental Health Bill was introduced in the House of Lords on 6 November 2024. Through our proposed reforms to the Mental Health Act, we want to ensure that people with a learning disability and autistic people get the support they need in the community, improve care, and prevent admission to hospitals.

If he will commission a review of emergency department staffing models to determine the (a) feasibility and (b) cost-effectiveness of embedding neurology teams in all major trauma centres.

The Department of Health and Social Care has no plans to commission such a review.

If he will create a national register for care workers to improve (a) professional recognition and (b) workforce mobility.

We have launched an independent commission into adult social care, chaired by Baroness Casey. The Commission's Terms of Reference are sufficiently broad to enable Baroness Casey to define its remit to independently consider how to build a social care system fit for the future. This includes considering professional registration if the Commission sees fit.There is also work underway to improve professional recognition and workforce mobility.In April 2025, the Department published the expanded and revised Care Workforce Pathway, including a new enhanced care worker role category. These pathway role categories will guide workers in building their careers in adult social care by signposting training and development opportunities, highlighting routes for progression, and giving proper recognition to the highly skilled, complex care and support they provide. Additionally, the Learning and Development Support Scheme, backed this financial year by up to £12 million, funds learning and development opportunities, including learning outcomes outlined in the Care Workforce Pathway. Overall, this work is essential for raising the status of adult social care as a career and recognising the vital work that care professionals do.

What steps NHS England is taking to ensure that A&E clinicians are trained to (a) recognise neurological red-flag symptoms and (b) initiate (i) plasma exchange, (ii) intravenous methyl-prednisolone and (iii) other urgent treatments.

All accident and emergency clinicians are trained to the highest standards to ensure the best patient care possible. Recognition of neurological emergencies is part of the emergency care curriculum, which is written by the Royal College of Emergency Medicine to the standards set by the medical regulator, the General Medical Council.

What recent assessment he has made of the potential impact of digital-first primary care systems on patients without internet access; and what steps he plans to take to reduce digital exclusion in the NHS.

People unable to access the NHS App or online services, or visit their general practice (GP) in person, can ask for a feature called proxy access available through the NHS App. This function allows a trusted relative or carer to act on the patient’s behalf and can be set up through the patient’s GP surgery, so that they can help them manage their health and care. This is done through a proxy, or linked, account. Depending on the access that the GP surgery has enabled, proxy users may be able to act for the person they support, by ordering repeat prescriptions, booking appointments, viewing test results or vaccinations, and accessing all or part of the GP health record, to help with health-related tasks and managing health issues.While digital health tools like the NHS App offer convenience, they should be part of a wider offering that includes face-to-face support with appropriate help for people who struggle to access digital services.NHS England has published a framework for National Health Service action on digital inclusion and is developing further resources to support practical actions. All programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion. Digital health tools are part of a wider offering that includes face-to-face support and telephone services, with appropriate help for people who struggle to access digital services.NHS England has successfully run a number of programmes to support patients, carers, and health service staff with their digital skills. These include: - the NHS App ‘Spoken Word’ Pilot project, designed to test the efficacy of promoting NHS digital health products and services in languages other than English;- the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online; and- the Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation, and means to access health information and services online. GP surgeries also offer patients non-digital methods to manage their primary and secondary healthcare, and these methods usually consist of telephonic communication and letters. Patients can request a non-digital route by registering their preference with their GP surgery.

What steps his Department is taking to ensure that patients who cannot use the internet retain (a) telephone or (b) in-person routes to (i) book GP appointments and (ii) access triage services.

People unable to access the NHS App or online services, or visit their general practice (GP) in person, can ask for a feature called proxy access available through the NHS App. This function allows a trusted relative or carer to act on the patient’s behalf and can be set up through the patient’s GP surgery, so that they can help them manage their health and care. This is done through a proxy, or linked, account. Depending on the access that the GP surgery has enabled, proxy users may be able to act for the person they support, by ordering repeat prescriptions, booking appointments, viewing test results or vaccinations, and accessing all or part of the GP health record, to help with health-related tasks and managing health issues.While digital health tools like the NHS App offer convenience, they should be part of a wider offering that includes face-to-face support with appropriate help for people who struggle to access digital services.NHS England has published a framework for National Health Service action on digital inclusion and is developing further resources to support practical actions. All programmes are actively considering how they can contribute to improvements in healthcare inequalities and digital inclusion. Digital health tools are part of a wider offering that includes face-to-face support and telephone services, with appropriate help for people who struggle to access digital services.NHS England has successfully run a number of programmes to support patients, carers, and health service staff with their digital skills. These include: - the NHS App ‘Spoken Word’ Pilot project, designed to test the efficacy of promoting NHS digital health products and services in languages other than English;- the Digital Health Champions programme, a proof of concept to support citizens who have no or low digital skills with understanding how to access health services online; and- the Widening Digital Participation programme, aimed to ensure more people have the digital skills, motivation, and means to access health information and services online. GP surgeries also offer patients non-digital methods to manage their primary and secondary healthcare, and these methods usually consist of telephonic communication and letters. Patients can request a non-digital route by registering their preference with their GP surgery.

Whether his Department plans to introduce a requirement for (a) 24-hour on-call neurology cover or (b) rapid tele-neurology support in all major emergency departments.

The Department has no plans to introduce a requirement for 24-hour on-call neurology cover or rapid tele-neurology support in all major emergency departments.

What the median waiting time is for an emergency department patient to receive a consultant neurologist review in hospitals that do not have an on-site neurology team.

The information requested is not held centrally.

What assessment his Department has made of the clinical impact of (a) delayed and (b) missed diagnosis of (i) autoimmune encephalitis and (ii) other acute neurological emergencies presenting to emergency departments without neurology cover.

The revised NHS England specialised neurology service specification, published on 13 August, following extensive consultation with clinical and charity partners, states that all patients should have access to acute neurology advice via a networked model of care. The national specialised commissioning team is also developing an integrated care system toolkit to support implementation, which includes acute neurology guidance.

How many Type 1 emergency departments in England currently operate without an on-site neurology service.

In 2021, NHS England’s Getting It Right First Time (GIRFT) programme shared its national specialty report for neurology following deep dive visits to all 24 neuroscience regions, then to the 67 trusts that together deliver neurology services to 139 sites.Data from the report shows that 28% of emergency admissions were at N4 sites, sties with a visiting neurologists only and no on-site service, and a further 4% at N5 sites, sites with no visiting neurologists.Building on the recommendations in the GIRFT national report, the NHS England Neurology Transformation Programme is developing guidance to support integrated care boards and service providers to deliver services for patients with acute neurological conditions efficiently and equitably.Earlier access to expert opinion improves outcomes and allows earlier discharge, reducing lengths of stay and inpatient care costs. Many admissions are potentially avoidable if appropriate ambulatory admission avoidance pathways for acute neurology are put in place.

What guidance he has issued to integrated care boards on commissioning pathways that guarantee immediate access to plasma exchange for patients with acute inflammatory neurological disorders.

NHS England’s Specialised Neurology service specification outlines a networked model of care for neurology and stipulates that all specialised neurology centres should have access to timely plasma exchange services to patients with severe autoimmune neurological disorders. Although secondary care hospitals will not ordinarily have plasma exchange services on site, all secondary care hospitals are linked to a regional specialised neurology centre that can offer this treatment in a timely way.

What funding has been allocated in the financial year 2025-26 to expand regional (a) neurological emergency networks and (b) tele-neurology services.

There is no formal structure or funding for neurological emergency networks. The acute neurology guidance forming part of the NHS England integrated care system neurology toolkit provides guidance on the organisation of services to ensure patients admitted to acute medical units are able to access neurological advice where necessary. Tele-neurology is available across the country as required.

On what date he last met with Baroness Casey to discuss her Commission on adult social care.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, engages with Baroness Louise Casey regularly on a number of issues, including adult social care.The commission is independent, and Baroness Casey has the autonomy to define her own engagement plans, including with ministers, based on what she believes is most appropriate for the commission’s work.