Written questions by Dillon.

What steps his Department is taking to support social care providers in Newbury with changes to employer National Insurance contributions.

The Government took the cost pressures facing adult social care into account as part of the wider consideration of local government spending within the Spending Review process.To enable local authorities to deliver key services such as adult social care, the Government is making up to £3.7 billion of additional funding available for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.The additional funding available to West Berkshire in 2025/26 means that they will see an increase to their core spending power of up to 5.7% in cash terms.Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all local people.

What assessment he has made of the potential impact of the proposed three-year implementation period for social care reforms on social care providers.

We are launching an independent commission into social care, chaired by Baroness Louise Casey. It will be undertaken in two phases, beginning in April 2025. Phase one, reporting in 2026, will identify the biggest challenges in adult social care and recommend practical changes to improve people’s lives over the next decade, and will help build the foundation for a National Care Service. Phase two, reporting by 2028, will make longer-term recommendations for the transformation of adult social care.Addressing the complex, deep-rooted challenges facing adult social care will take time. The commission will work with people who draw on care, their families, staff, politicians, providers, and the public, private, and third sector, to make clear recommendations for how to reform the adult social care system to meet the current and future needs of the population.In parallel, the Government is also committed to short-term progress, as we recognise that the issues facing adult social care are pressing. We are making up to £3.7 billion of additional funding available for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant. This represents an increase to core local government spending power in 2025/26 of 6.8% in cash terms.

Whether he has plans to increase access to NHS dental services in Newbury constituency.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the 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.The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to the integrated care boards (ICBs) across England. For the Newbury constituency, this is the Buckinghamshire, Oxfordshire and West Berkshire ICB.

What steps his Department is taking to tackle childhood obesity; and whether he has made an assessment of the potential merits introducing measures to improve access to affordable, nutritious food options.

The prevention of ill health is a clear priority for the Government, and a cornerstone of this is supporting children to live healthier lives. Under the Health Mission, the Government is committed to prevention and to tackling obesity, creating a fairer, healthier food environment. We have already laid secondary legislation to restrict advertisements of less healthy food and drink to children on television and online, we have announced changes to the planning framework for fast food near schools, and we are taking steps to ensure the Soft Drinks Industry Levy remains effective and fit-for-purpose. In addition, initiatives such as the Healthy Start scheme, free school meals, and the holiday activities and food programme provide access to affordable, nutritious food options. The Healthy Start scheme, introduced in 2006, encourages a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. Pregnant women and families with children aged over one and under four years old each receive £4.25 every week, and families with children under one years old each receive £8.50 every week. Healthy Start can be used to buy, or be put towards the cost of, fresh, frozen, or tinned fruit and vegetables, fresh, dried, or tinned pulses, milk, and infant formula. Healthy Start beneficiaries also have access to free Healthy Start vitamins.Disadvantaged pupils in state-funded schools, as well as 16 to 18-year-old students in further education, are entitled to receive free meals on the basis of low income. In addition, all children in Reception, Year 1, and Year 2 in England's state-funded schools are entitled to universal infant free school meals. The holiday activities and food programme provides free childcare places, enriching activities, and healthy meals to children from low-income families, benefiting their health, wellbeing, and learning throughout the school holidays.We are also working collaboratively across the Government to deliver a resilient food system that promotes health and food security. The Food Strategy will work to provide healthier, more easily accessible food to help people live longer, healthier lives.

Pursuant to the Answer of 18 November 2024 to Question 12879 on Employer national insurance contributions on pharmacies, whether an impact assessment was conducted prior to the decision to increase employer National Insurance contributions.

A Tax Information and Impact Note (TIIN) was published alongside the introduction of the bill containing the changes to employer National Insurance contributions. The TIIN sets out the impact of the policy on the exchequer, the economic impacts of the policy, and the impacts on individuals, businesses, and civil society organisations, and an overview of the equality impacts.

Pursuant to the Answer of 19 November 2024 to Question 901298 on leases for GP premises, if he will review the decision to delegate the authority to hold GP leases to integrated care boards.

The GP (General Medical Services) Contract terms ordinarily require the contractor to hold the premises liability.NHS England also holds the right to hold operational estate and has delegated the power to hold leases to integrated care boards (ICBs). However, bringing ICBs into any formal leasing structure creates capital accounting liabilities, and these would need to be considered in the context of any request to directly hold operational estate.NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. Whilst we know this not the most effective use of ICB resources, it is an important safeguard.Given where the liabilities lie within contracts and the power already held by ICBs to provide exceptional support, it is not deemed necessary to seek to amend any rules or guidance.We are committed to fixing the front door of the National Health Service by supporting GPs and ICBs through, for example, the £102 million of capital funding announced at the Budget for GP estate upgrades.

If he will take steps to support pharmacies in Newbury constituency with the increased cost of employers National Insurance contributions.

We have taken necessary decisions to fix the foundations in the public finances at Autumn Budget 2024, which enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The employer national insurance rise will be implemented April 2025, with the Department setting out further details on allocation of funding for this year in due course.

What steps his Department is taking to support research in the pharmaceutical sector in Newbury.

The Department funds research and research infrastructure, which supports patients and the public to participate in high-quality research across the United Kingdom, through the National Institute of Health and Care Research (NIHR).Development and delivery of research in the pharmaceutical sector is supported and enabled nationwide through NIHR infrastructure, including the NIHR Research Delivery Network (RDN), the NIHR Clinical Research Facilities (CRFs), the NIHR Biomedical Research Centres (BRCs), and the newly designated NIHR Commercial Research Delivery Centres (CRDCs). These all support the delivery of clinical research through facilities, staff resource, collaborations, and funding.In Newbury, pharmaceutical research benefits from the South Central RDN, as well as the Oxford and Southampton-based CRFs and BRCs, and from April, a new CRDC in Southampton, all of which support a range of pharmaceutical studies in the region.In order to maximise our potential to be a world leader and develop a more competitive, efficient, and accessible clinical research system, the Department is committed to implementing the recommendations from Lord O'Shaughnessy’s independent review of commercial clinical trials in full. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the United Kingdom, to provide innovative treatment options for patients.

What steps he is taking to ensure the provision of adequate (a) palliative and (b) end-of-life care in Newbury.

Palliative care services are included in the list of services that integrated care boards (ICBs), including Buckinghamshire, Oxfordshire and Berkshire West ICB, which covers the Newbury constituency, must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.NHS England has also developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those their local population, thereby enabling ICBs to put plans in place to address and track the improvement of health inequalities.I met NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care. Additionally, we have committed to develop a 10-Year Health Plan, to deliver a National Health Service fit for the future, as part of which we will carefully be considering policies, including those that impact people with palliative and end of life care needs, with input from the public, patients, health staff, and our stakeholders as we develop the plan. More information about how they can input into the 10-Year Health Plan is available at the following link: https://change.nhs.uk/en-GB/

What steps his Department is taking to support the Pharmacy First campaign.

There is a targeted public communications campaign with associated media materials, running from 11 November 2024 until mid-December 2024 as well as coordinated communications across the healthcare system and sharing best practices where the service is already working well.Action is also being taken to drive further engagement and referrals from general practice, with targeted engagement through regional and integrated care board (ICB) channels and regular data to support managing performance. In addition to this, funding has been provided to ICBs to recruit primary care network engagement leads who will be well placed to support practice teams to refer into the service.Additionally, NHS England is improving digital systems to make the referral process better integrated, including further development of electronic referral systems. Most pharmacies can now also receive Pharmacy First referrals from general practitioners straight into their NHS England assured pharmacy IT systems.

If he will conduct a review of the decision to delegate the power to hold leases for GP premises to integrated care boards.

NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. While we know that is not the most effective use of ICB resources, it is an important safeguard. We are committed to fixing the front door of the NHS by supporting GPs and ICBs through, for example, the £100 million of capital funding announced at the Budget for GP estate upgrades.

What steps his Department is taking to ensure that the clean air policy addresses the risks of (a) carbon monoxide and (b) other indoor air pollutants.

The UK Health Security Agency (UKHSA) works in partnership with other organisations to develop advice and recommended actions which can improve detection of, and prevent accidental exposure to, carbon monoxide in homes. This includes participating in a cross-Government group on gas safety and carbon monoxide awareness, which promotes a joined-up approach to improving gas safety and reducing carbon monoxide poisoning risks.The UKHSA Clean Air Programme includes efforts both to build the evidence base and raise awareness of indoor air quality and its health impacts. Furthermore, the National Institute for Health and Care Excellence has published guidance on indoor air quality at home, designed to raise awareness of the importance of good air quality in people's homes and advise on how to achieve this.Building regulations already require that carbon monoxide alarms are fitted alongside the installation of fixed combustion appliances of any fuel type, excluding gas cookers, in all tenures. The ingress of outdoor air can affect indoor air quality, and the Government is committed to delivering a comprehensive and ambitious Clean Air Strategy.

With reference to paragraph 2.40 of the Autumn Budget 2024, HC 295, published on 30 October 2024, what assessment he has made of the potential impact of the rise in the rate of employer national insurance contributions on pharmacies.

We have taken tough decisions to fix the foundations in the public finances at Autumn Budget. This enabled the Spending Review settlement of a £22.6 billion increase in resource spending for the Department from 2023/24 outturn to 2025/26. The employer national insurance rise will be implemented April 2025, the Department will set out further details on allocation of funding for next year in due course.

What steps he is taking with Cabinet colleagues to provide adequate funding for research into blood cancer (a) treatment and (b) care; and what steps he is taking to help tackle delays in blood cancer diagnosis.

The Department funds research into blood cancer through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23. The NIHR spends more on cancer than any other disease group.In blood cancer research, the NIHR is funding the £2.6 million PROPEL trial, testing whether a package of enhanced personalised prehabilitation can help people with acute myeloid leukaemia cope better with treatment. The NIHR is also funding a £3 million trial of the drug ibrutinib for treatment of chronic lymphocytic leukaemia, and a £2.2 million study to evaluate the digital health platform, AscelusTM, for management of blood disorders, including cancers.The NIHR welcomes funding applications for research into any aspect of human health, including all cancers. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.We are committed to improving cancer survival rates and hitting all National Health Service cancer waiting time standards within five years, so no patient waits longer than they should. We will also address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce waits.We are committed to achieving the Faster Diagnosis Standard, which aims to ensure patients have cancer diagnosed or ruled out within 28 days of referral from a general practice (GP) or screening services. We are expanding direct access to diagnostic scans across all GPs, helping to cut waiting times and speeding up a cancer diagnosis or all-clear for patients. The NHS is implementing non-specific symptom pathways for patients who present with vague and non-specific symptoms, which do not clearly align to a cancer type. This aims to reduce the delays experienced by some patients, and are expected to be of particular benefit to people presenting with signs and symptoms that could be due to blood cancer.

What steps he is taking to reduce dermatology waiting times.

Tackling waiting lists is a key part of our Health Mission. We will deliver an extra 40,000 operations, scans, and appointments, including dermatology appointments, each week, as a first step in our commitment to ensuring that patients can expect to be treated within 18 weeks.We will be supporting National Health Service trusts to deliver these through innovation, sharing best practice to increase productivity and efficiency, and ensuring the best value is delivered.The Government is committed to putting patients first. This means making sure that patients across all specialties, including dermatology, are seen on time, and ensuring that people have the best possible experience during their care.

Whether his Department has made an assessment of the potential impact of waiting times from GP referral to first appointment with dermatology clinic on patients; and what data his Department holds on average such waiting times (a) for NHS Buckinghamshire, Oxfordshire and Berkshire West ICB and (b) nationally.

The Government is committed to putting patients first. This means making sure that patients are seen on time and ensuring that people have the best possible experience during their care, including for dermatology.Whilst no formal assessment has been made of the potential impact of waiting times from general practice (GP) referral to first appointment with a dermatology clinic on patients, dermatology services are being transformed to make sure that patients are seen on time. NHS England’s Getting It Right First Time (GIRFT) programme is working with National Health Service trusts to deliver rapid clinical transformation, with the aim of reducing the numbers of patients waiting more than 52 weeks. The work brings together clinicians and operational teams to work collectively to transform patient pathways, reduce unnecessary appointments, and improve access and waiting times for patients.A clinical transformation group for dermatology was established in summer 2023, focusing on sharing and learning from best practice. Topics for collaboration have included innovative clinic models, for instance super clinics, best practice in the use of technology for telemedicine, best practice in reducing Did Not Attends, reducing unnecessary follow ups through Patient Initiated Follow Up, the role of artificial intelligence, how to develop nurses into advanced roles, and factors to help motivate and retain staff.GIRFT is also planning a programme to support primary care colleagues, offering training for new staff to recognise harmless skin lesions, like moles and warts, with the aim of reducing unnecessary referrals to hospital and freeing up capacity for other patients on the waiting list.Unpublished management information, as of 29 September 2024, from NHS England gives the average wait time for those waiting for first activity on a dermatology pathway of 15.4 weeks for the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board, compared to 13.9 across the whole of England.

What steps he is taking to ensure that new parents receive adequate support.

The Government has an ambition to achieve the healthiest generation of children ever. A strong child health focus will need to underpin both the Health and Opportunity Missions.The zero- to five-year-olds element of the Healthy Child Programme is a universal, personalised service, led by health visitors and family nurses, for new parents, and reaches 97% of families. Every family should be offered five visits, including antenatal and new birth contact, alongside targeted support for families who require additional help. £3.6 billion was allocated to local authorities through the Public Health Grant in 2024/25, which is used to fund the delivery of the Healthy Child Programme.The Family Hubs and Start for Life Programme provides support for babies and their families in the critical 1,001 days from conception to the age of two. It provides approximately £300 million over three years to 75 local authorities in England with high levels of deprivation to create a network of Family Hubs, with Start for Life services at its core. Support for new parents and carers with babies includes: perinatal mental health support and services, to promote positive early relationships; face-to-face and virtual infant feeding services; and increased capacity for the National Breastfeeding Helpline.The Healthy Start scheme, introduced in 2006, encourages a healthy diet for pregnant women, babies, and young children under four years old from very low-income households.

If he will make an assessment of the potential merits of taking steps to increase the number of clinical academics dedicated to blood cancer research.

The Department, through the National Institute for Health and Care Research (NIHR), is the largest funder of clinical academic training in the United Kingdom, delivering a comprehensive research career pathway for the full range of clinicians. The NIHR welcomes applications for training awards from the clinical and non-clinical academic workforce conducting research into any aspect of human health, including blood cancer. The NIHR continuously reviews the training offer to identify and address gaps across specialism, geography, and profession, in line with the Department’s priorities.

If he will make funding for the National Breastfeeding Helpline's overnight service permanent.

Breastfeeding has significant benefits for both mothers and babies and it’s important that families are supported to meet their infant feeding goals.The Family Hubs and Start for Life programme has funded the expansion of the National Breastfeeding Helpline, helping families across the country to access virtual breastfeeding support. This includes a pilot of the night-time service from March 2024, ensuring help is available at all times of the day and night, every day of the year.The night service pilot is currently funded to run until the end of March 2025, and we will independently evaluate the pilot to inform future decisions on funding for this service.

Whether he has made an assessment of the potential impact of long waiting times for an assessment of neurodevelopmental conditions on children.

The NHS England national framework and operational guidance for autism assessment services, and the National Institute for Health and Care Excellence (NICE) quality standard for autism, set out that diagnostic assessments should happen as soon as possible so that appropriate health, social care, and education interventions, as well as advice and support, can be offered.The Department is currently considering next steps to improve diagnostic assessments and support for autistic people and for people with attention deficit hyperactivity disorder (ADHD).It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism and ADHD services, in line with relevant NICE guidelines. This includes support for children and young people whilst waiting for an assessment.On 5 April 2023, NHS England published a national framework and operational guidance to help ICBs and the National Health Service to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. The guidance also sets out what support should be available before an assessment and what support should follow a recent diagnosis of autism. In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.In respect of ADHD, we are supporting a cross-sector taskforce that NHS England has launched for the challenges in ADHD service provision, to help provide a joined-up approach in response to concerns around rising demand