Written questions by Dillon.

What assessment he has made of the potential impact of local authority funding pressures on recruitment and retention in the adult social care workforce.

No specific assessment has been made on the potential impact of local authority funding pressures on recruitment and retention in the adult social care workforce.English local authorities have a responsibility under the Care Act 2014 to meet social care needs and statutory guidance directs them to ensure there is sufficient workforce in adult social care. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce.The Government is making over £4.6 billion of additional funding available for adult social care in 2028/29 compared to 2025/26, to support the sector in making improvements. This includes £500 million to introduce the first ever Fair Pay Agreement in 2028 to improve pay and conditions for the adult social care workforce.

What assessment he has made of the potential impact of changes to employer National Insurance contributions on providers of council-commissioned adult social care services.

The Government took the cost pressures facing adult social care, including changes to employer National Insurance contributions and increases to the National Living Wage, into account as part of the wider consideration of local government spending.To enable local authorities to deliver key services such as adult social care, the Government has made available up to £3.7 billion of additional funding for social care authorities in 2025/26. The Government also made an extra £502 million of support for local authorities in England to manage the impact of changes to employer National Insurance Contributions announced at the Autumn Budget for 2025/26.In addition, the final Local Government Finance Settlement has confirmed an increase of over £4.6 billion of funding available for adult social care in 2028/29 compared to 2025/26. Under the Care Act 2014, local authorities are responsible for shaping their care markets to meet local needs. In doing so, they should have an understanding of the local market, work effectively with local providers, and maintain oversight of local workforce pressures. It is for them to determine what is a sustainable rate, suitable to their local circumstances.

What assessment his Department has made of whether current local authority funding for adult social care will be sufficient for projected demand over the next three years.

The Department regularly assesses the demand and cost pressures facing adult social care. These pressures were taken into account as part of the wider consideration of spending within the Spending Review process.The Government is making additional funding available for adult social care to support the sector in making improvements. The total additional funding available for adult social care in 2026/27 compared to 2025/26 is over £1.6 billion, rising to over £4.6 billion in 2028/29.This includes additional grant funding, growth in other sources of income available to support adult social care, and an increase to the National Health Service contribution to adult social care via the Better Care Fund, in line with the Department’s Spending Review settlement.

What assessment his Department has made of the (a) prevalence of respiratory disease and (b) number of emergency hospital admissions for respiratory conditions in Newbury constituency compared with the national average; and what steps he is taking to prioritise respiratory health nationally.

Data is available for emergency Finished Admission Episodes (FAEs) where there was a primary diagnosis of 'respiratory conditions’. The following table shows the number of FAEs where there was a primary diagnosis of 'respiratory conditions’ for the Newbury constituency, for activity in English National Health Service hospitals and English NHS commissioned activity in the independent sector, for 2024/25 and provisionally for 2025/26: Westminster Parliamentary Constituency of Residence2024/25 (August 2024 to March 2025)2025/26 (April 2025 to November 2025)Newbury895695England612,855511,558Source: Hospital Episode Statistics, NHS England. Available data on trends in respiratory conditions can be found on the Department’s Fingertips dataset. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority, and integrated care board level. Information for Newbury can be found under the West Berkshire county at the following link: https://fingertips.phe.org.uk/search/Respiratory#page/1/gid/1/pat/15/ati/502/are/E06000037/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

What assessment he has made of the potential merits of extending business rates relief o community pharmacies providing NHS services.

I refer the Rt Hon. Member to the answer I gave to the Hon. Member for Farnham and Bordon on 23 February 2026 to Question 113205.

What plans he has to make training in palliative and end-of-life care mandatory for health and care professionals.

There are no current plans to make training in palliative care and end-of-life care mandatory for health and care professionals.We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. To ensure the health and social care workforce is equipped and well supported to deliver personalised care to people at the end of life, Health Education England, now part of NHS England, hosts the End of Life Care for All e-learning training programme, which includes nine modules on improving care for people at the end of life.Independent statutory regulatory bodies such as the General Medical Council (GMC) and the Nursing and Midwifery Council have the general function of promoting high standards of education and coordinating all stages of education to ensure that health and care students and newly qualified healthcare professionals are equipped with the knowledge, skills, and attitudes essential for professional practice.The training curricula for postgraduate specialty training, including palliative care and end-of-life care, is set by the relevant royal college and have to meet the standards set by the GMC.For general practitioners (GPs), the Royal College for General Practice has established the GP with Extended Roles (GPwER) in Palliative and End of Life Care Framework. The GpwER framework sets out standards, capabilities, training requirements, supervision and governance for GPs working beyond core practice, including in palliative and end-of-life care.

What steps he is taking to improve out-of-hours access to medicines for people at the end of life.

The Government is committed to ensuring that people at the end of life can access the medicines they need, including outside of normal pharmacy opening hours.Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end-of-life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England’s statutory guidance states that ICBs work with community pharmacies, out-of-hours providers and palliative care teams to ensure timely access to medicines, including through locally commissioned services that make end of life medicines available on a 24/7 basis.Additionally, those nearing the end of life who are likely to need symptom control can be prescribed anticipatory medicines with written instructions for how to use or administer treatment. These medicines are often called 'just in case' medicines and may be provided in a specially marked container called a 'just in case' box. The medicines are prescribed in advance so that they can be obtained during local pharmacy opening hours and kept safely at home, or at a care home, so that the person or their carer has access to them if they develop symptoms. Providing medicines in advance means that there is no delay in getting medicines that might be needed quickly to help with symptoms. The use of anticipatory prescribing is recommended in the National Institute for Health and Care Excellence guideline, Care of dying adults in the last days of life.Furthermore, the Government will publish a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England later this year. The MSF will drive improvements in the services that patients and their families receive at the end of life and enable ICBs to address challenges in access, quality and sustainability through the delivery of high-quality, personalised care.

What steps he is taking to improve 24-hour Urgent Community Response services for people at the end of life.

The Government is committed to ensuring that people approaching the end of life receive high-quality, compassionate care whenever it is needed.Urgent community response (UCR) services play a key role in this. UCR provides a two-hour community-based response to adults experiencing a sudden deterioration in their health and helps avoid unnecessary hospital admissions. People at the end of life are among those who can be referred into UCR services for urgent crisis, for symptom control and/or pain relief, in line with a person’s wishes.We are committed to improving the consistency, capacity, and availability of UCR services across England. The Urgent and Emergency Care Delivery Plan 2025/26 includes actions to expand urgent care delivered in the community, including UCR, and the National Health Service 10-Year Health Plan further commits to increasing access to urgent care at home and in the community as part of the new Neighbourhood Health model.Additionally, NHS England’s published statutory guidance on palliative care and end-of-life care states that integrated care boards, as commissioning authorities, must define how their local service providers meet population needs on a 24/7 basis.The National Institute for Health and Care Excellence (NICE) guideline, NG142: End of life care for adults: service delivery, also recommends that adults nearing the end of life have access to a healthcare professional 24 hours a day, seven days a week, as well as an out-of-hours advice line and access to essential medicines for symptom management.Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.Furthermore, to strengthen provision for people at the end of life, we will publish a Palliative Care and End-of-Life Care Modern Service Framework (MSF) later this year. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, including strengthening out-of-hours community health support, dedicated telephone advice, and overall consideration of 24/7 provision.

What steps he is taking to ensure that rural dispensing GP practices in Newbury have a sufficient supply of aspirin.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand.The Department is aware of a recent disruption to the supply of aspirin tablets due to manufacturing issues and knock-on increased demand. The issues have been addressed, and we are working with suppliers to aid a return to normal supply as soon as possible, with stock regularly being made available for pharmacies to order. Guidance has been issued to healthcare professionals with management advice to consider until the supply issue fully resolves.We are working with all partners in the supply chain, including manufacturers and United Kingdom distributors, to ensure maximum accessibility to pharmacies and hospitals irrespective of where they are in the country.The Department will continue to monitor the situation and expects supplies to return to normal over the coming weeks.

What support he is providing to dispensing GP practices in Newbury to help prevent shortages of aspirin.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand.The Department is aware of a recent disruption to the supply of aspirin tablets due to manufacturing issues and knock-on increased demand. The issues have been addressed, and we are working with suppliers to aid a return to normal supply as soon as possible, with stock regularly being made available for pharmacies to order. Guidance has been issued to healthcare professionals with management advice to consider until the supply issue fully resolves.We are working with all partners in the supply chain, including manufacturers and United Kingdom distributors, to ensure maximum accessibility to pharmacies and hospitals irrespective of where they are in the country.The Department will continue to monitor the situation and expects supplies to return to normal over the coming weeks.

What steps he is taking to simplify the navigation of care pathways for patients and general practitioners.

The 10-Year Health Plan sets out that the NHS App will also allow patients to book appointments, communicate with professionals, receive advice, draft or view their care plan, and self-refer to local tests and services. These developments will streamline how patients move through the system and support clearer navigation of their care. We are also improving digital access in general practices (GPs), including online request routes, modernising triage models, and strengthening care navigations. GPs are responsible for their own clinical knowledge and advising patients on the most appropriate care pathways. To support this, we are delivering the recommendations of the Red Tape Challenge to remove unnecessary administrative burdens between primary and secondary care. The new Advice and Guidance scheme gives GPs specialist advice, reducing unnecessary referrals and helping patients reach the right care first time.

What steps he is taking to improve out-of-hours support for people at the end of life.

The Government is committed to ensuring that people approaching the end of life receive high-quality, compassionate care whenever it is needed.Urgent community response (UCR) services play a key role in this. UCR provides a two-hour community-based response to adults experiencing a sudden deterioration in their health and helps avoid unnecessary hospital admissions. People at the end of life are among those who can be referred into UCR services for urgent crisis, for symptom control and/or pain relief, in line with a person’s wishes.We are committed to improving the consistency, capacity, and availability of UCR services across England. The Urgent and Emergency Care Delivery Plan 2025/26 includes actions to expand urgent care delivered in the community, including UCR, and the National Health Service 10-Year Health Plan further commits to increasing access to urgent care at home and in the community as part of the new Neighbourhood Health model.Additionally, NHS England’s published statutory guidance on palliative care and end-of-life care states that integrated care boards, as commissioning authorities, must define how their local service providers meet population needs on a 24/7 basis.The National Institute for Health and Care Excellence (NICE) guideline, NG142: End of life care for adults: service delivery, also recommends that adults nearing the end of life have access to a healthcare professional 24 hours a day, seven days a week, as well as an out-of-hours advice line and access to essential medicines for symptom management.Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.Furthermore, to strengthen provision for people at the end of life, we will publish a Palliative Care and End-of-Life Care Modern Service Framework (MSF) later this year. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, including strengthening out-of-hours community health support, dedicated telephone advice, and overall consideration of 24/7 provision.

What steps he is taking to improve timely access to general practice appointments.

We are committed to improving timely access to general practice appointments. Last year, we delivered 6.8 million more appointments in general practices. Since October 2024, we have invested £160 million into the Additional Roles Reimbursement Scheme (ARRS) to support the recruitment of over 2,000 general practitioners (GPs), exceeding our initial target of 1,000. For the 2026/27 GP Contract, we’re investing an additional £485 million into GPs, removing restrictions to allow primary care networks to hire more GPs via ARRS, and introducing a practice-level reimbursement scheme which will be available to practices to hire additional GPs, or fund additional sessions with existing GPs to improve access in GPs which aims to strengthen capacity, access, and improve patient satisfaction. NHS England published the Medium‑Term Planning Framework in October, setting a new requirement for all urgent appointments to be delivered on the same day, ensuring that patients needing urgent care are prioritised. Building on this, the 2026/27 GP Contract makes it explicit that any requests identified as clinically urgent, as determined by the GPs, must be dealt with on the same day Patient satisfaction is already rising after a decade of decline. Office for National Statistics data from January 2026 shows that 76.8% of patients reported it was “easy” to contact their GP, up from 60.9% in July 2024.

What assessment his Department has made of the potential implications for its policies of data published by NHS England on waiting times for children and young people to begin community eating disorder treatment.

The Government keeps data published by NHS England on waiting times for children and young people’s community eating disorder services under close review.We recognise that demand for services has increased and that performance varies across the country. That is why we are reforming eating disorder services so that children and young people can access timely, effective support when they need it, rather than after their condition has escalated.This shift towards prevention and stronger community-based support underpins the new National Health Service guidance for children and young people’s eating disorder services. The Government is also recruiting 8,500 additional mental health workers across the NHS to increase capacity and reduce unwarranted variation in waiting times.We will continue to work with NHS England and the integrated care boards to improve performance against national access standards and ensure children and young people can access high-quality care regardless of where they live.

What steps he is taking to establish a national delivery model for NHS-commissioned clinical services for pupils in schools.

The Government is committed to raising the healthiest generation of children ever. The National Health Service is responsible for meeting the health needs of children and young people diagnosed with an illness or medical condition, including long term conditions.On 5 February 2026, NHS England published ‘Standardising community health services – core component descriptions’ to support integrated care boards’ strategic commissioning of Community Health Services. This guidance sets out the core components and responsibilities of a special school nursing service and community children's nursing service, including the roles of these services in supporting children with medical conditions to access education settings. The document is available at the following link:https://www.england.nhs.uk/publication/standardising-community-health-services-core-component-descriptions/

Whether his Department plans to engage key stakeholders on the assumptions underpinning workforce modelling in the NHS Long Term Workforce Plan.

The 10 Year Workforce Plan will set out action to create a National Health Service workforce able to deliver the transformed service set out in the 10-Year Health Plan. It is important we do this in a robust and joined up way. We are therefore engaging extensively with partners to ensure this plan delivers for staff and patients.A formal call for evidence took place between 25 September and 7 November 2025, which provided stakeholders with the opportunity to contribute directly to the plan’s development. This was part of an ongoing and extensive programme of engagement, including several roundtables and an event hosted last year by ministers, which was attended by nearly one hundred representatives of partner organisations.Insight from this engagement has informed the development of assumptions underpinning the plan’s modelling, which will also be subject to independent scrutiny from external experts.

What progress is being made towards meeting the 18-week referral-to-treatment standard, as set out in the Elective Recovery Plan.

NHS England’s Operational Planning Guidance for 2025/26 set a target that, by the end of March 2026, 65% of patients wait no longer than 18 weeks.To achieve this, we expect the size of the total waiting list to reduce and have already made significant progress. As of December 2025, the waiting list had reduced by over 330,000 since the Government came into office. This is despite 31.7 million referrals onto the waiting list. Performance against the referral to treatment standard had improved by 2.7% over the same period, reaching 61.5%.This has been supported by the delivery of 5.2 million additional appointments between July 2024 and June 2025 compared to the previous year, more than double the Government’s pledge of two million. This marked a vital first step towards delivering the constitutional standard.

What recent assessment the Government has made of the effectiveness of the Online Safety Act 2023 in addressing online content that encourages, promotes or provides instructions relating to eating disorders.

The Government recognises the serious harm caused by online content that encourages, promotes or provides instructions relating to eating disorders.The Online Safety Act 2023 makes platforms legally responsible for keeping people, especially children, safe online. All providers must mitigate the risks of illegal harm, including encouraging serious self-harm, on their services. Services likely to be accessed by children must also take steps to mitigate risks to children, including exposure to content relating to eating disorders.Ofcom is responsible for ensuring that services uphold these duties. Its ‘Small But Risky Services Taskforce’ focuses on smaller platforms that host or promote the most acute harms, including self-harm and eating disorder content. These services are identified not by their size, but by the disproportionate level of harm they may present to UK users. The Taskforce has already engaged extensively with high-risk services associated with eating disorders and has assessed over 20 services relating to this harm, with over half identified as high-risk for eating disorder content.The Department continues to work across Government to ensure that online safety measures support wider public health objectives and protect children and young people from harmful content.

What assessment his Department has made of the adequacy of the performance of AJM Healthcare in delivering wheelchair services to the NHS.

The safety of all patients, whether they are treated in the National Health Service or the independent sector, is a top priority for the Government. There are a range of providers of NHS wheelchair services across England. Integrated care boards (ICBs) are responsible for monitoring service provision and effectively managing contracts with their commissioned providers.NHS England are aware there have been a number of separate complaints about the quality of services provided by AJM Healthcare, which are being dealt with on an individual basis by the Ombudsman’s office. NHS England supports ICBs to make improvements and commission effective, efficient, and personalised wheelchair services. Actions taken include:- establishing a national wheelchair dataset, where data has been collected quarterly from ICBs, formerly clinical commissioning groups, since July 2015 and which supports the drive for improvements in wheelchair services. This data looks at waiting times across the pathway to enable targeted action if improvement is required. Further information is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/national-wheelchair/- the Wheelchair Quality Framework, which was published on the 9 April 2025, and which was co-produced with key stakeholders, including Whizz Kids. The framework sets out quality standards and statutory requirements for ICBs, such as offering personal wheelchair budgets, with further information available at the following link: https://www.england.nhs.uk/long-read/wheelchair-quality-framework/- personal wheelchair budgets, with NHS England having introduced personal wheelchair budgets, including in legal rights, in 2019, providing a clear framework for ICBs to commission personalised wheelchair services which are outcomes focused and integrated. Personal wheelchair budgets give people greater choice over the wheelchair provided, with further information available at the following link: https://www.england.nhs.uk/publication/guidance-on-the-legal-rights-to-have-personal-health-budgets-and-personal-wheelchair-budgets/

If he will make it his policy to end the use of body mass index as a criterion for determining eligibility for joint replacement surgery.

It is the responsibility of individual integrated care boards to determine clinical commissioning policies for their local areas, including eligibility for joint replacement surgery.As with all surgery, body mass index (BMI) should be considered as part of a holistic, personalised perioperative evaluation of the risks versus the clinical need for joint replacement surgery of an individual patient. BMI should not be considered in isolation as a barrier to surgery.As part of the NHS Elective Reform Plan, the Government has committed to expanding access to the NHS Digital Weight Management Programme for patients waiting for hip and knee replacements. This will help optimise patients for their surgery, potentially leading to a reduced length of hospital stay and minimising their risk of post-operative complications.