Written questions by Naish.

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 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 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.

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.

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.

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.

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.

With reference to NHS England's website entitled Health and wellbeing programmes, what steps he is taking to improve (a) rest areas and (b) catering facilities for NHS staff.

The NHS Health and Wellbeing Framework highlights the importance of getting the basics right, such as providing access to good quality rest areas, food, and drink options. Through the Independent Review of NHS Hospital Food, officials have had, and continue to have, discussions in relation to improving catering for National Health Service staff in NHS hospital settings. The NHS Food and Drink Standards also contains detailed information for catering managers about sourcing and serving high quality, nutritious food to patients and staff. As set out in the 10-Year Health Plan, we will work with the Social Partnership Forum to introduce a new set of staff standards for modern employment, covering issues such as access to healthy meals and support to work healthily and flexibly. The New Hospital Programme will mandate that staff welfare spaces must occupy at least 6% to 7% of the total net internal area footprint for schemes that are fully compliant with the new standardised designs. This 6% to 7% minimum allocation will continue to be protected and maintained through the full life cycle of the building.

Whether his Department plans to extend funding for the NHS Practitioner Health programme beyond March 2026.

Looking after the mental health of our hardworking National Health Service staff is a priority for the Government.The NHS Practitioner Health programme is funded until March 2026, and more recently the 10-Year Health Plan committed to rolling out Staff Treatment Hubs. These hubs will provide a high-quality occupational health service for all NHS staff, which includes support for mental health issues.

With reference to his Department's policy paper entitled Fit for the future: 10 year health plan for England, published in July 2025, when he expects David Lock KC’s review of clinical-negligence costs to (a) commence and (b) publish its findings.

David Lock KC was appointed on 30 June 2025 to provide expert advice on the rising legal costs of clinical negligence, and on how to improve patients’ experiences of claims, ahead of a review by the Department in the autumn. He has commenced work on this review and expects to be in a position to provide advice to ministers in the early autumn. No decisions have yet been made as to whether any review will be published.Details of the outcome of the Department’s review will be announced at the earliest opportunity.

What steps he plans to take to update the regulatory framework for the General Dental Council.

The Government is committed to modernising the regulatory frameworks for healthcare professionals in the United Kingdom. The Government is aiming to publish a consultation on secondary legislation to modernise the General Medical Council’s (GMC) regulatory framework in late 2025. This legislation will be the blueprint for the reform of all of the healthcare professional regulators. In addition to the GMC’s legislation, we aim to deliver reformed legislation for the Health and Care Professions Council and the Nursing and Midwifery Council within this Parliament. No timeframe has yet been set for reforming the General Dental Council’s legislative framework.

If he will make an assessment of the potential impact of NICE’s severity modifier on people with 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, 81.1% compared to 69%.Since the introduction of the severity modifier, 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 methods reviews.

What assessment he has made of the adequacy of NICE’s definition of a very severe condition.

The National Institute for Health and Care Excellence (NICE) introduced the severity modifier in 2022 to replace the existing end of life modifier, based on evidence of societal preferences and as part of a comprehensive review of NICE’s methods and processes. The modifier was designed through extensive public and stakeholder engagement and in line with the principle of opportunity cost neutrality. NICE’s updated methods, including the severity modifier, have enabled it to recommend a number of treatments for conditions such as hepatitis D and cystic fibrosis, that it may not otherwise have been able to recommend for use on the National Health Service. Under these new methods, the proportion of positive recommendations is higher, at 86.5%, than with the end-of-life modifier, at 82.5%.NICE has commissioned research to gather further evidence on societal preferences that will inform future methods reviews.

What steps he is taking to ensure that people with incurable secondary breast cancer have access to world-leading treatments.

NHS England announced in April 2025 that eligible women with secondary breast cancer could soon have access to a new targeted treatment, capivasertib, used alongside fulvestrant, on the National Health Service.In May, NHS England announced the world’s first roll out of liquid biopsy testing, which is now available for all eligible breast cancer patients, and which aims to speed up diagnosis and inform better treatment options for those with breast cancer.

What steps he is taking to (a) increase and (b) ensure the ongoing availability of medical radioisotopes for NHS services.

The Department regularly engages with suppliers, specialist clinicians, the British Nuclear Medicine Society, and the UK Radiopharmacy Group to support the continued supply of medical radioisotopes for the National Health Service. The Department continues to work with the NHS and other parts of the Government to better understand future needs for medical radioisotopes.

What information his Department holds on the number of appointments in (a) Nottingham University Hospitals NHS Trust, (b) the East Midlands and (c) the UK that have been delayed due to a lack of availability of medical radioisotopes in 2025 to date.

While we do not typically hold this information centrally, the Department is aware that the number of appointments delayed related to radioisotope supply issues at the Nottingham University Hospitals NHS Trust for the period of January 2025 to May 2025 consist of: - 68 patients delayed for a fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography scan; - 48 patients delayed for a F-18 FDG, prostate-specific membrane antigen positron emission tomography/computed tomography scan; and - 57 patients delayed across multiple nuclear medicine tests. We do not hold the information for the East Midlands more widely, or for the United Kingdom as a whole. The Department regularly engages with suppliers, specialist clinicians, the British Nuclear Medicine Society, and the UK Radiopharmacy Group to support the continued supply of medical radioisotopes for National Health Services. The Department continues to work with the NHS and other parts of the Government to better understand future need for medical radioisotopes.

What assessment he has made of the potential impact of family hubs on (a) neighbourhood health and (b) the effectiveness of the delivery of integrated community-based health services.

We are committed to moving towards a Neighbourhood Health Service, with more care delivered locally to create healthier communities, spot problems earlier, and support people to stay healthier and maintain their independence for longer.The Family Hubs and Start for Life programme supports the three reform shifts set out in the Government’s Health Mission, including the shift from hospital to community. It is already delivering a community-based model to transform health outcomes for babies, children, and their families.The effectiveness of the programme will take time to be realised, as long-term evaluation is required. The programme is subject to two national, independent evaluations to understand its implementation and impact.

What progress his Department has made on implementing the Family Hubs and Start for Life programme.

The Family Hubs and Start for Life programme is now in its fourth year of delivery, and we are seeing important progress. 75 local authorities have established a network of family hubs and are providing universal, preventative services that benefit babies, children, and their families. Local authorities are developing services based on local need to improve health and educational outcomes, delivered through integrated, multi-agency workforces. Through Start for Life funding, families with babies can access support for perinatal mental health, parent-infant relationships, and infant feeding.The effectiveness of the programme will take time to be realised, as long-term evaluation is required. The programme is subject to two national, independent evaluations to understand its implementation and impact. We are already seeing evidence of promising progress as demonstrated by the thematic review undertaken by the Care Quality Commission and Ofsted.

What steps his Department is with manufacturers of blood transfusion sampling bottles to improve their design.

NHS Blood and Transplant (NHSBT) is responsible for collecting and processing blood donations across England, to meet hospital demand for treating patients.Blood collection tubes are used to collect blood samples at the time of blood donation. These samples are used to perform mandatory and discretionary infectious disease marker screening and blood grouping at every donation. Additional samples are taken from apheresis donors for tests such as haemoglobin levels, total protein testing. Sample tubes are also used for quality monitoring of components.NHSBT is not aware of any issues surrounding the current containers and is therefore not actively working with manufacturers of blood transfusion sampling bottles, as the current design meets their needs.

Whether the forthcoming 10 Year Health Plan will include measures to integrate (a) welfare and (b) debt advice provision into primary care settings.

As part of the 10-Year Health Plan, Neighbourhood Health Centres will co-locate National Health Service, local authority and voluntary sector services, to help create an offer that meets population need holistically. Examples of this include providing debt advice and employment support services.