Written questions by Madders.

What steps he is taking to improve suicide prevention support in Cheshire and Merseyside.

Awaiting answer.

What steps he is taking to implement the suicide prevention strategy.

Awaiting answer.

If he will make an estimate of the number of mental health staff recruited in the Cheshire and Merseyside ICB area since July 2024.

Awaiting answer.

What assessment he has made of the adequacy of suicide prevention support in Cheshire and Merseyside.

Awaiting answer.

What assessment he has made of the availability of specialist eating disorder support for patients in Ellesmere Port and Bromborough.

The Department is working closely with NHS England to strengthen community-based eating disorder (ED) services and to improve outcomes and recovery for patients, including in Ellesmere Port and Bromborough. Integrated care boards (ICBs) are responsible for commissioning mental health services for local populations. In doing so, ICBs are expected to be evidence-based by assessing and responding to the needs of their local communities and to ensure services are provided equitably. Young people, between 13 and 18 years old, from Ellesmere Port and Bromborough access specialist ED care at Ancora House, the specialist General Adolescent Unit for Young Peoples mental health Services in Cheshire and Merseyside. There is a Day Hospital provision called Sapphire which offers a range of therapeutic interventions for young people with an ED. Care is also provided from the Cheshire and Merseyside Eating Disorder Service who are based at Ancora House. If specialist inpatient care is required, there are four dedicated beds at Ancora house, co-located with the ED Day Hospital. Adults with an ED from the Ellesmere Port and Bromborough area are supported in the specialist Community Eating Disorders service. If specialist inpatient care is required, patients receive this at the Oaktrees Specialist Eating Disorders Unit on the Clatterbridge Health Park. NHS England has also published new guidance on children and young people’s EDs, which places greater emphasis on early identification and intervention across the care pathway, including in schools and primary care settings.

What steps he is taking to enable patients with eating disorders in Ellesmere Port and Bromborough constituency to access specialist services.

Integrated care boards are responsible for commissioning mental health services for local populations. In Ellesmere Port and Bromborough, young people access specialist eating disorder services at Ancora House. A clinical assessment will determine which level of care they require to meet their needs. Adult patients in Ellesmere Port and Bromborough access specialist eating disorder services through a specialist community eating disorders service (CEDS). This is accessed by referral by general practitioner or other health professional. If the CEDS assess the patient as requiring specialist inpatient care, the patient will be referred into the Oaktrees Specialist Eating Disorders Unit where a multidisciplinary team of clinicians assess suitability for admission.

What estimate he has made of the number of patients referred to care outside the local area for patients with eating disorders in Ellesmere Port and Bromborough constituency.

We do hold this data, however as it is below five at the current time we cannot provide an exact value. This is standard statistical disclosure control guidance, where counts of less than five are suppressed to stop individuals being identified.

What assessment he has made of the suitability of the provision of specialist eating disorder support for patients in Ellesmere Port and Bromborough constituency.

The Department is working closely with NHS England to strengthen community-based eating disorder services and to improve outcomes and recovery for patients, including in Ellesmere Port and Bromborough. Integrated care boards (ICBs) are responsible for commissioning mental health services for local populations. In doing so, ICBs are expected to be evidence-based by assessing and responding to the needs of their local communities and to ensure services are provided equitably. The services offered to young people, those aged 13 to 18 years old, with an eating disorder are monitored for safety, quality, and performance by the Lead Provider Collaborative (LPC) Commissioning Team. A team of clinicians within the LPC work with the Cheshire and Wirral Partnership NHS Foundation Trust and people with lived experience of eating disorder services to ensure they meet required quality, performance, and patient/carer standards. NHS England has also published new guidance on children and young people’s eating disorders, which places greater emphasis on early identification and intervention across the care pathway, including in schools and primary care settings.

What assessment had been made by DHSC or provided to DHSC by NHS England about the potential impact on the NHS of proposed changes to introduce the full refund model for VAT in the NHS.

The Department has not made a formal published assessment of the potential impact on the National Health Service of the proposed changes to introduce a full refund model for VAT under section 41 of the Value Added Tax Act 1994.The Department of Health and Social Care and NHS England have engaged with HM Treasury and HM Revenue and Customs through cross-Government discussions to understand the potential implications of the proposals for the NHS, including the interaction with NHS funding flows and the principle that any reform would need to be fiscally neutral.NHS England has provided input to the Department to support this engagement, including analysis of existing VAT recovery arrangements and high-level consideration of the potential impacts of moving from the current Contracted Out Services regime to a full refund model. This work has been undertaken to inform cross-Government discussions and data-gathering exercises led by HM Treasury, rather than as a standalone assessment of the impact on NHS services.

What response was provided by DHSC to the consultation by HM Treasury around changes to the VAT treatment of public bodies under Section 41 of the VAT Act.

The Department of Health and Social Care did not submit a formal response to HM Treasury’s consultation on proposed changes to the VAT treatment of public bodies under section 41 of the Value Added Tax Act 1994.The consultation, VAT and the Public Sector: Reform to VAT Refund Rules, was published by HM Treasury on 27 August 2020 and closed on 19 November 2020.As a central Government department, the Department of Health and Social Care engaged with HM Treasury and HM Revenue and Customs through cross-Government discussions to consider the potential implications of the proposals for the health and care system, including National Health Service bodies, rather than responding as a stakeholder in its own right.

Whether his department has made representations outlining concerns to NHS England about multiple Trusts and FTs in the North West engaging in activities around the proposed formation of or changes to subcos without following the guidance provided by NHS England in February 2024.

Outsourcing transactions which involve the creation of new subsidiaries, or material changes to existing subsidiaries, including any proposals in the North West, are reportable to NHS England for review in line with its published subsidiary transaction guidance. NHS England wrote to the sector on 26 September 2025 to highlight a change in national policy on subsidiaries given concerns about transferring National Health Service staff into new organisations, which is seen as undermining the concept of a single NHS workforce. NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access. All subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions. This includes any proposals in the North West.

What steps have been taken to ensure NHS England enforces the guidance around the formation of subcos.

Outsourcing transactions which involve the creation of new subsidiaries, or material changes to existing subsidiaries, including any proposals in the North West, are reportable to NHS England for review in line with its published subsidiary transaction guidance. NHS England wrote to the sector on 26 September 2025 to highlight a change in national policy on subsidiaries given concerns about transferring National Health Service staff into new organisations, which is seen as undermining the concept of a single NHS workforce. NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access. All subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions. This includes any proposals in the North West.

What information is being provided to his Department by NHS England on the progress on insourcing previously outsourced services within the NHS.

We do not routinely collect data on outsourcing or insourcing arrangements. Outsourcing transactions which involve the creation of new subsidiaries or material changes to existing subsidiaries are reportable to NHS England for review in line with its published subsidiary transaction guidance.As set out on 26 September 2025, NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of National Health Service staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access. Subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions.

What information his Department is collecting to monitor progress towards reducing the level of outsourcing in the NHS.

We do not routinely collect data on outsourcing or insourcing arrangements. Outsourcing transactions which involve the creation of new subsidiaries or material changes to existing subsidiaries are reportable to NHS England for review in line with its published subsidiary transaction guidance.As set out on 26 September 2025, NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of National Health Service staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access. Subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions.

What action will be taken against NHS Trusts that do not follow guidance from NHS England around proposals to consider the formation of a subco.

Outsourcing transactions which involve the creation of new subsidiaries, or material changes to existing subsidiaries, including any proposals in the North West, are reportable to NHS England for review in line with its published subsidiary transaction guidance. NHS England wrote to the sector on 26 September 2025 to highlight a change in national policy on subsidiaries given concerns about transferring National Health Service staff into new organisations, which is seen as undermining the concept of a single NHS workforce. NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access. All subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions. This includes any proposals in the North West.

Whether any NHS Trusts are developing proposals for new SubCos.

National Health Service trust proposals to establish subsidiary companies are reviewed by NHS England in line with its published subsidiary transaction guidance. NHS England has one proposal under formal consideration. As set out on 26 September 2025, NHS England will shortly consult on updating national guidance to confirm that subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances and only where there is clear local union support and protection of NHS terms and conditions, including pension access.

What steps his Department has taken to assess compensation for those living with Fetal Valproate Spectrum Disorder.

The Department continues to take forward work to explore redress for those affected by pelvic mesh and sodium valproate, which includes recommendations made by the Patient Safety Commissioner in the Hughes Report. We recognise the importance of these issues for all those affected. This remains a cross-Government policy area involving multiple organisations, and given the complexity of the issues involved, it is important we get this right.I met with the Patient Safety Commissioner in December 2025, to discuss progress following the Hughes Report and have made clear the Department’s expectation of continued, proactive engagement with the Patient Safety Commissioner and key stakeholders.

What steps he is taking to improve survival rates of out of hospital cardiac arrests in the North West.

We recognise that there is more to do to improve cardiac arrest survival, including in the North West. The 10-Year Health Plan sets out the reforms and radical shifts needed to improve National Health Services and deliver better patient outcomes and includes a focus on improving cardiovascular disease detection and prevention. Key initiatives include improving the early detection and treatment of high-risk conditions like atrial fibrillation, high blood pressure, and high cholesterol, known as 'the ABCs', to prevent heart attacks and strokes, which can lead to cardiac arrest.

What steps he is taking to reduce deaths from cardiovascular disease.

The Government is committed to reducing premature mortality from heart disease and stroke by 25% in the next 10 years. To accelerate progress towards this ambition, we will publish a Modern Service Framework for Cardiovascular Disease (CVD) in 2026, which will identify the best evidenced interventions, and drive innovation in prevention, treatment, and care. The Department and NHS England are working closely to deliver the CVD modern service framework and will engage widely throughout its development.Alongside this, the NHS Health Check, a core component of England’s CVD prevention programme which aims to detect those at risk of heart disease and stroke aged between 40 and 74 years old, engages over 1.4 million people and through behavioural and clinical interventions, prevents approximately 500 heart attacks and strokes a year. To improve access with the programme, we are piloting an NHS Health Check online service so that people can undertake a check at a time and place that is convenient to them.We have invested in hypertension case-finding for those over 40 years old in community pharmacies, and nearly 4.2 million people have received a free blood pressure check through the service since October 2021.

Whether he has considered plans to fully fund the specialist palliative care, advice and assessment provided by hospices.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087, which I gave to the House on 24 November 2025.