Written questions by Naish.

What steps he is taking to reduce waiting times for musculoskeletal services in Rushcliffe constituency; and if he will consider the use of chiropractors as regulated healthcare professionals to reduce those waiting times.

NHS England does not nationally commission chiropractic care as it is a complementary and alternative medicine. There are no plans to make an assessment of the potential merits of integrating chiropractic care into centrally commissioned National Health Service care.Where there is demand, integrated care boards are able to make independent decisions on which health professionals they employ and may commission a limited amount of such treatment.Cutting waiting lists forms a key part of the Government’s mission to reform the NHS.

Whether he has had discussions with Independent Sector Providers on ensuring that staff (a) who deliver NHS services and (b) whose contracts do not include automatic pay uplifts receive any agreed pay uplifts as soon as possible.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not held any discussions with independent providers on this topic.Independent organisations, such as social enterprises and general practices, are free to develop and adapt their own terms and conditions of employment. This includes the pay scales that they use, the extent to which pay awards are made, and when those awards are paid.

Whether he is taking steps to ensure that the Community Pharmacy Independent Prescribing Pathfinder Programme and independent prescribing generally will continue to be supported to maximise direct prescribing capability in England.

The NHS England Pathfinder programme is running across England with the aim of developing a commissioning framework for community pharmacy clinical services with independent prescribing (IP) for National Health Service patients. We are working with integrated care boards and pathfinder sites, community pharmacies, to understand the key enablers for IP to be incorporated into community pharmacy. The programme learning will be across five key domains: clinical; digital; governance and safety; people; and funding and contracts. We hope to complete our evaluation by Autumn 2025, and to use this to inform planning for the incorporation of prescribing into community pharmacy clinical services. Further information on the NHS England Pathfinder programme is available at the following link:https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-integration-fund/independent-prescribing/

Whether his Department has made an assessment of the potential merits of providing additional support for pharmacies to dispense medication in multi-compartment compliance aids to vulnerable patients.

The Equality Act 2010 requires pharmacies to make reasonable adjustments for patients with protected characteristics. Multi-compartment compliance aids are one of many reasonable adjustments available, however, they are not always the most appropriate option. Patients should be assessed on a case-by-case basis to find the right intervention for them.Pharmacies are expected to fund reasonable adjustments required under the Equality Act 2010 from the fees they receive for essential services as part of the Community Pharmacy Contractual Framework. We are working at pace with Community Pharmacy England to ensure that the funding we have available is used to support community pharmacy in the best way possible.

If he will review the use of NHS Shared Business Services by non-NHS services for (a) payroll, (b) pension, (c) procurement, (d) tax accounting and (e) other financial services.

The NHS Shared Business Services provides corporate and back-office services, including payroll, pensions, procurement, and accounting services, to National Health Service organisations and health-related social enterprises only.

Whether his Department has plans to review allergen labelling requirements for non-prepacked foods and beverages; and whether he plans to take steps to implement the Food Standards Agency's recommendations for improving allergen information at the point of sale.

The Food Standards Agency (FSA) has policy responsibility for food safety, including food allergen labelling, in England, Wales, and Northern Ireland, and is working to improve the availability and accuracy of allergen information for non-prepacked foods, which includes foods made to order in restaurants.In December 2023, the FSA Board agreed that businesses selling non-prepacked foods, such as cafes and restaurants, should provide allergen information to consumers in writing, and that this should be supported by a conversation. Following the Board’s decision, FSA officials are working to assess the impact of different legislative options for improving the provision of allergen information for non-prepacked foods.Officials in the Department for Environment, Food and Rural Affairs and the Department of Health and Social Care are being kept closely informed on the progress of this work.In parallel, taking a steer from the Board, the FSA has created best practice guidance for businesses to provide written allergen information and support this with a conversation, which has recently been through a public consultation. This guidance, along with tools to assist businesses in following it, will be published shortly.

What NHS guidance and training is available to ensure Complex Regional Pain Syndrome is understood by medical professionals across England; and whether his Department plans to issue further guidance.

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS) and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information about the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on Complex Regional Pain Syndrome (CRPS). Research has focused on establishing evidence–based management of CRPS to improve clinical outcomes throughout the care pathway.There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, diagnosis, and treatment pathway, which is available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What research is being conducted on the (a) causes, (b) symptoms and (c) suitable treatments for Complex Regional Pain Syndrome.

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS) and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information about the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on Complex Regional Pain Syndrome (CRPS). Research has focused on establishing evidence–based management of CRPS to improve clinical outcomes throughout the care pathway.There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, diagnosis, and treatment pathway, which is available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What data is collected on the prevalence of Complex Regional Pain Syndrome in England; and how this data is being used to understand the condition.

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS) and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information about the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on Complex Regional Pain Syndrome (CRPS). Research has focused on establishing evidence–based management of CRPS to improve clinical outcomes throughout the care pathway.There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, diagnosis, and treatment pathway, which is available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What research his Department is undertaking on the (a) causes, (b) symptoms and (c) treatment for complex regional pain syndrome (CRPS).

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS), and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information on the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on complex regional pain syndrome (CRPS). Research has focused on establishing evidence-based management of CRPS to improve clinical outcomes throughout the care pathway. There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, and diagnosis and treatment pathway, available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and the GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What data is collected on the prevalence of Complex Regional Pain Syndrome in England; and how this data is being used to understand the condition.

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS), and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information on the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on complex regional pain syndrome (CRPS). Research has focused on establishing evidence-based management of CRPS to improve clinical outcomes throughout the care pathway. There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, and diagnosis and treatment pathway, available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and the GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What NHS guidance and training is (a) in place and (b) being put in place to ensure Complex Regional Pain Syndrome is understood by medical professionals across England.

The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) is part of the National Disease Registration Service (NDRS), and NHS England. The NCARDRS aims to collect, curate, quality-assure, and analyse data from patients in England diagnosed and/or treated with rare conditions. Further information on the NCARDRS and the NDRS is available, respectively, at the following two links:https://digital.nhs.uk/ndrs/about/ncardrshttps://digital.nhs.uk/ndrsOver the last five financial years, the National Institute for Health and Care Research has allocated £189,109 for research on complex regional pain syndrome (CRPS). Research has focused on establishing evidence-based management of CRPS to improve clinical outcomes throughout the care pathway. There is a National Health Service conditions page dedicated to CRPS, detailing the symptoms, causes, and diagnosis and treatment pathway, available at the following link:https://www.nhs.uk/conditions/complex-regional-pain-syndrome/NHS England’s Genomics Education Programme and the GeNotes resource provides concise information to help healthcare professionals make the right decisions at each stage of a clinical pathway. GeNotes also includes resources on non-genetic rare diseases, and work continues to expand the programme's coverage.

What support is available for dental practices to (a) relocate to and (b) open new practices in underserved areas.

Dental practices are private businesses and therefore able to decide how they operate. It is their own responsibility to secure dental premises. The responsibility for commissioning primary care services, including National Health Service dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. For Rushcliffe constituency, this is Nottingham and Nottinghamshire ICB.The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.Integrated Care Boards have started to recruit posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. As of 10 February 2025, in England, 35 dentists were recruited and in post, a further 33 dentists were recruited but yet to start in post, and a further 249 posts are currently advertised.

What steps his Department is taking to help to care for the estimated 47,000 people affected by polio in the UK.

Although there is currently no cure for post-polio syndrome, a range of treatments and support is available to help manage the symptoms and improve quality of life.Once post-polio syndrome is identified, patients with the condition can usually be managed through routine access to primary or secondary care provided via a general practitioner or consultant. Treatment will depend on the severity of a patient’s condition, but may involve pain-relieving medication, physiotherapy, dietary and exercise advice, and counselling or cognitive behavioural therapy.Commissioners, providers and clinicians, supported by relevant clinical practice, determine the best treatment for people with post-polio syndrome.

Whether he plans to review the use of NHS Shared Business Services for finance services such as (a) payroll, (b) pensions, (c) procurement and (d) taxation.

NHS Shared Business Services provides these services though contract framework agreements which it hosts. In late 2023, NHS England launched an Accredited Framework Host programme and successfully accredited 20 Procurement Framework Host organisations, of which NHS Shared Business Services is one, all of whom have subscribed to enhanced standards. These standards cover a range of areas, from minimum contractual terms & conditions, robust supplier appointment and value for money assessment processes, through to sharing of commercial and commission data with NHS England.Further details and the list of accredited host organisations such as NHS Shared Business Services are available at the following link:https://www.england.nhs.uk/long-read/system-guidance-for-the-implementation-of-framework-host-management/

What steps his Department is taking to increase the number of (a) supervisor and (b) designated prescribing practitioners.

NHS England is investing in training for independent prescribers, as well as initiatives to support the development and safe practice of designated prescribing practitioners (DPPs) and educational supervisors. This will ensure the National Health Service is ready to support and mentor foundation trainee pharmacists from 2025, alongside training for currently registered pharmacists that are learning to be independent prescribers.Reforms to pharmacist education and training will allow for development of prescriber pharmacists from the point of registration from 2026. This will enable a career-long focus on prescriber services and an associated expansion of the DPP workforce, to support multi-professional teams and the expansion of cross-sector prescribing services.

If he will simplify the process for obtaining Maternity Exception Certificates.

There are no plans to revise the application process for maternity exemption certificates that provide entitlement to free National Health Service prescriptions. The NHS Business Services Authority has advised that in 2024, 48,063 Penalty Charge Notices were issued to those who indicated they held a valid maternity exemption certificate that could not be validated.

What steps he is taking to support healthcare providers to ensure (a) uninterrupted access to essential patient care and (b) maintain the stability of primary care services.

It is vital that patients can access primary care services when they need it.In October 2024, we provided an £82 million boost to the Additional Roles Reimbursement Scheme, enabling the recruitment of 1,000 newly qualified general practitioners (GPs) across England. This will take pressure off the existing workforce, secure the future supply of GPs and increase the number of appointments delivered in general practice. We have uplifted a monthly payment to practices by 7.4% to fund a 6% increase in pay to the general practice workforce. We have also announced a proposed £889 million uplift to the GP contract for 2025/26, the largest uplift in years, with a rising share of total National Health Service resources going to general practice. We are currently consulting the profession on key proposals to improve access, continuity of care and GP recruitment.We are working to ensure patients can start to access 700,000 additional urgent NHS dental appointments as soon as possible, targeting areas that need them most. To rebuild NHS dentistry in the long term, we will reform the dental contract with a shift to focus on prevention and the retention of NHS dentists. We are committed to stabilising the pharmacy sector and building a service fit for the future, making full use of the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.

If he will make an assessment of the potential merits of increasing non-academic routes for people to train as nurses.

We have a complete apprentice pathway for nursing, from entry level to postgraduate advanced clinical practice. NHS England is expanding routes into healthcare professions through apprenticeships. Our 10-Year Health Plan to reform the National Health Service will establish how to train and provide the staff the NHS needs, including nurses, through all training routes, to care for patients across our communities. A refreshed NHS Long Term Workforce Plan due for publication in summer 2025 will deliver the transformed health service we will build over the next decade, ensuring the NHS has the right people, in the right places, with the right skills to give the care patients need when they need it.

How many people have been fined for accessing prescriptions without a valid Maternity Exception Certificate.

There are no plans to revise the application process for maternity exemption certificates that provide entitlement to free National Health Service prescriptions. The NHS Business Services Authority has advised that in 2024, 48,063 Penalty Charge Notices were issued to those who indicated they held a valid maternity exemption certificate that could not be validated.