Written questions by Shannon.

What assessment he has made of recent trends in levels of sustainability of GP practices in rural areas.

We recognize that patients are struggling to access general practice (GP), and more must be done to improve the sustainability of the National Health Service both nationally and in rural areas. The Government is committed to fixing the front door to the NHS, which is crucial for its long-term sustainability.We acknowledge the urgent challenge of ensuring rural areas have the resources to continue serving their patients. To address this, we will increase funding for GPs and primary care, and shift the focus of the NHS from hospitals to community-based care. We will also ensure rural areas have the necessary workforce to provide integrated, patient-centered services.We are committed to training thousands more GPs across the country, including in rural areas, starting with the training places outlined in the NHS’s Long-Term Workforce Plan. This will increase capacity, secure the future pipeline of GPs, and alleviate the pressure on those currently working in the system.We are pleased to announce that newly qualified GPs will be included in the Additional Roles Reimbursement Scheme as part of an initiative to address GP unemployment, with additional funding over 2024/25. This is a step in the journey while the Government works with GPs to identify longer term solutions to GP unemployment and sustainability.Additionally, we have accepted the DDRB recommendations in full and, subject to consultation with the BMA, we will uplift the pay element of the GP contract by 6% on a consolidated basis (an increase of 4% on top of the 2% interim uplift in April); to provide practices with funding to uplift GP partner, salaried GP and other salaried staff pay by 6%.

What steps he is taking to help increase the (a) survival rate for out-of-hospital cardiac arrests and (b) availability of defibrillators in public and community settings.

As of July 2024, there are 93,113 automated external defibrillators registered in the United Kingdom on the National Defibrillator Network, also known as The Circuit, including 73,682 in England. Going forward, the Department has asked Professor Lord Darzi to investigate the state of the National Health Service, and will then set out its 10 year plan for the NHS.

What steps he is taking to (a) increase public awareness and (b) reduce stigma in men about early screening for prostate cancer.

The Department actively supports campaigns to increase public awareness of the symptoms of prostate cancer. NHS England is running the Help Us Help You campaigns to raise awareness of cancer symptoms, including symptoms of prostate cancer, and to encourage people to come forward to see their general practitioner (GP). The Prostate Cancer Risk Management Programme provides GPs with information to counsel asymptomatic men aged 50 years old and over about Prostate Specific Antigen (PSA) testing for prostate cancer.NHS England has also partnered with Cancer Alliances, charities, and local representatives to reach people through projects in the heart of their communities. Cancer Alliances have been undertaking action to alert at-risk groups about prostate cancer at a local level, where needed.There is no current screening programme for prostate cancer in the United Kingdom. This is because of the inaccuracy of the current best test, a prostate-specific antigen (PSA) test. A PSA-based screening programme could harm men, as some of them would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments, which can also have harmful side effects. However, we are backing groundbreaking trials to improve diagnostic processes and save thousands more lives. This includes a £42 million UK-wide TRANSFORM trial, aimed at helping find the best way of screening for prostate cancer, to which the Department is providing £16 million.

What steps his Department is taking with social care providers to ensure that the social care sector meets required staffing levels.

The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth, and to reduce the reliance on international recruitment. We want it to be regarded as a profession, and for the people who work in care to be respected as professionals.Those working in social care have been ignored for too long, and so will be at the heart of our initial reforms. We will engage with the workers and trade unions to deliver a long over-due new deal for care workers, including establishing the first ever Fair Pay Agreement for care professionals, learning from countries where they operate successfully.

What steps he is taking to help tackle rickets.

Rickets is a condition that affects bone development in children. Cases of rickets are rare in the United Kingdom, and have been relatively consistent over recent years. The most common cause of rickets is a lack of vitamin D and calcium, although in rare cases, children can be born with a genetic form of the condition.Since it is difficult for people to get enough vitamin D from food alone, the Government advises that everyone should consider taking a daily 10-microgram vitamin D supplement during the autumn and winter. People at high risk of not getting enough vitamin D, pregnant and breastfeeding women, all children aged one to four years old, and all babies, unless they're having more than 500 millilitre of infant formula a day, should take a daily supplement throughout the year. People at high risk of not getting enough vitamin D include:⎯ those who are not often outdoors, for example if they're frail or housebound;⎯ are in an institution like a care home;⎯ usually wear clothes that cover up most of their skin when outdoors; and⎯ those who have dark skin, such as people with an African, African-Caribbean or south Asian background. Government advice on vitamin D is communicated via the NHS.UK website and the social marketing campaigns Start4Life, Better Health, and Healthier Families. Through our Healthy Food Schemes, like Healthy Start, Nursery Milk, and the School Fruit and Vegetable Scheme, the Government provides a nutritional safety net to those who need it the most. Beneficiaries of our food scheme Healthy Start are eligible for free Healthy Start vitamins, which include vitamin C and D. The law also requires the addition of vitamin D to all infant formula.

If he will make an assessment of the adequacy of diagnosis rates for pancreatic cancer in the last 12 months.

We will improve cancer survival rates by hitting all National Health Service cancer waiting time targets within five years, including for pancreatic cancer. We know that pancreatic cancer is difficult to diagnose due to the non-specific nature of its symptoms. To improve diagnosis and outcomes, NHS England is delivering a range of interventions including implementing non-specific symptom pathways for patients who have symptoms that do not align to a single tumour type, as is often the case with pancreatic cancer. 96 pathways are in place, and more are being introduced. NHS England is also increasing general practice direct access to diagnostic tests, alongside providing a route into pancreatic cancer surveillance for those at inherited high-risk, to identify lesions before they develop into cancer and diagnose cancers sooner.The most recent Faster Diagnosis Standard performance for upper gastrointestinal cancers, including oesophageal cancer, stomach cancer, small bowel cancer, pancreatic cancer, liver cancer and cancers of the biliary system, is 76% against the 75% standard for May 2024.

How many people have been admitted to hospital following a drug overdose in the last 12 months.

Information on hospital admissions is not available in the format requested. NHS England publishes data on the number of admissions due to accidental and intentional poisoning by substance type. This information is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2022-23

If he will make it his policy to publish an action plan to help tackle heart disease.

The NHS Long Term Plan set an aim to prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029, and activity is underway. However, we know there is more to do to tackle cardiovascular disease, including heart disease. That is why in our Health Mission to Build an NHS Fit for the Future, we have committed to reducing deaths from heart disease and strokes by a quarter within 10 years. The Department and NHS England are working together on this ambitious mission, and we will share more in due course.

What plans he has to roll-out self-sampling cervical cancer tests.

A recently published YouScreen study provides evidence on offering a self-sampling test to non-attenders in the NHS Cervical Screening Programme. The UK National Screening Committee (UK NSC) plans to review this evidence and make a recommendation by the e...

If he will take steps with the food industry to help reduce the calorie content of processed foods.

The Government recognises that prevention will always be better, and cheaper, than a cure, and we will take preventative public health measures to tackle the biggest killers and to support people in living longer, healthier lives.As suppliers of what we eat and drink, the food industry has a key role to play in supporting the health of the nation. The voluntary calorie reduction programme requires businesses in all sectors to reduce the level of calories in the everyday food we buy for consumption, in or out of the home. This delivers change that will enable consumers to eat more healthily, without having to change their usual diets. Processed foods in scope of the programme include pizzas, crisps, sandwiches, and ready meals.Retailers and manufacturers are required to reduce calorie levels by 10%, and out of home businesses, including takeaway and delivery, are required to reduce calorie levels by 20%, against a 2017 baseline. Up to 25% of all adult energy intake is consumed out of the home, and foods and dishes served in the out of home sector generally contain double the levels of calories seen in similar products purchased in supermarkets, which is why they have a higher target.The first progress report on the voluntary programme showed generally little change in calorie levels across all sectors and categories between 2017 and 2021, so it is clear that more needs to be done. The Government recognises that we face an obesity crisis and need to act. As set out in the King's Speech, the Government will bring forward the necessary secondary legislation to ban junk food advertising to children, and to stop the sale of high-caffeine energy drinks to under-16-year-olds.

If he will have discussions with the Northern Ireland Health Minister on the provision of NHS dental care in Northern Ireland.

Whilst the provision of National Health Service dental care is devolved, My Rt hon. Friend, the Secretary of State for Health and Social Care intends to engage fully with Ministers from all four nations on matters crucial to the future of our health and social care system. My Rt hon. Friend will keep me updated on these discussions.

Whether his Department is taking steps to ensure that people who are eligible for IVF treatment receive three cycles of NHS-funded treatment.

Funding decisions for health services in England are made by integrated care boards (ICBs), and are based on the clinical needs of their local population. Organisations are expected to commission fertility services in line with the National Institute for Health and Care Excellence’s guidelines, which are based on the clinical evidence of the most effective treatment. The Department will be working with NHS England to support ICBs in improving the current National Health Service offer for patients.

What steps his Department is taking to provide (a) enhanced diagnostics and (b) treatment for people under the age of 16 who have allergies.

The Government is committed to ensuring that all people with allergies, including those under 16, have access to the services they need to manage their condition. The majority of those with allergies can be supported by locally commissioned services, with specialist allergy clinics available for those with more severe or complex allergic conditions.Specialist allergy services are commissioned by NHS England Specialised Commissioning in line with the published Service Specification. This sets out that providers should deliver a diagnostic package for the investigation of suspected allergic diseases, including initial consultation and follow-up in a dedicated allergy clinic and specialised allergy tests. There are regular review meetings between the regional commissioning teams and providers to ensure compliance with service standards.To support healthcare professionals, including those in primary care settings, in the implementation of clear care pathways, the National Institute for Health and Care Excellence (NICE) has published guidance on the diagnosis and treatment of drug and food allergy in people aged under 19 years old. The guidance aims to improve diagnosis by offering advice on how to identify allergies and when to refer to secondary or specialist care.The Royal College of General Practitioners have added allergy training to the new General Practitioner (GP) curriculum (2019) and, to support existing GPs, it has developed an allergy e-learning resource. Both resources aim to educate GPs about the various symptoms of allergic disease and to ensure that people with allergies can be effectively supported at primary care level.While there are no specific treatments for allergies for those under 16 years old, the National Health Service website recommends the below treatments for allergies: medicines for mild allergic reactions like antihistamines, steroid tablets and steroid creams; emergency medicines called adrenaline auto-injectors, such as an EpiPen, for severe allergic reactions; and desensitisation, or immunotherapy, for severe allergic reactions, involving carefully exposing an individual to the thing they are allergic to over time, so that their body gradually gets used to it and does not react so badly. This should only be done by a medical professional.

If he will make an assessment of the implications for his policies of the volume of salt in processed meat.

Processed meats are generally high in salt and, on average, meat and meat products contribute approximately 27% of salt intakes. A high intake of salt increases the risk of high blood pressure which, in turn, increases the risk of heart disease or a stroke. Reducing salt in foods by 1 gram per day, for example, could prevent 1,500 premature deaths each year, saving the National Health Service over £140 million.To reduce salt levels in foods, the voluntary salt reduction programme sets targets for different food and drink product categories that contribute to salt intakes, including processed meats such as ham, bacon, and sausages. Businesses across all sectors of the food industry are required to work towards these targets. Separate targets on a meal basis have been set for the out of home sector, which includes processed meats where appropriate.The targets were first set in 2006 and have been revised downwards five times to continually reduce salt content, with the most recent targets published in 2020. Businesses are expected to achieve the latest levels set by the end of 2024.The most recent assessment of industry progress suggests that small reductions in salt content were seen in some meat products between 2017 and 2018. Salt intakes decreased from 9.38 grams to 8.4 grams a day between 2000 and 2018/19.

What plans he has to roll out Fracture Liaison Services.

More than 500,000 fragility fractures occur every year, and up to 40% of fracture patients will suffer another fracture. I am pleased to reiterate the Government’s commitment to expanding access to fracture liaison services. The Department is working closely with NHS England to develop plans to ensure better quality and access to these important preventive services.

How many and what proportion of people were medically treated for severe nerve pain in the last 12 months.

The following table shows a breakdown of the Finished Admission Episodes (FAEs) in England with a primary diagnosis relevant to nerve pain, as well as the total number and proportion of FAEs with a primary diagnosis relevant to nerve pain, for 2023/24:DiagnosisAdmissionsDisorders of trigeminal nerve3,005Facial nerve disorders5,405Disorders of other cranial nerves210Cranial nerve disorders in diseases classified elsewhere285Nerve root and plexus disorders1,660Nerve root and plexus compressions in diseases classified elsewhere10,510Mononeuropathies of upper limb47,290Mononeuropathies of lower limb4,225Other mononeuropathies1,770Total FAEs with primary diagnosis relevant to nerve pain74,365Total 2023/24 FAEs17,540,975Proportion of admissions with primary diagnosis relevant to nerve pain0.42%Source: Hospital Episode Statistics (HES), published by NHS EnglandNotes:- FAEs refer to the first period of admitted patient care under one consultant within one healthcare provider, and are generally counted against the year or month in which the admission episode finishes, so do not represent the number of patients, as a person may have more than one admission within the period;- the primary diagnosis is the first of up to 20 diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital;- the data is provisional and may be incomplete or contain errors for which no adjustments have been made, as counts produced from provisional data are likely to be lower than those generated for the same period in the final data set; and- all counts have been rounded to the nearest five and values less than 10 have been supressed.