Written questions by Smart.

What estimate his Department has made of the number of complaints received by NHS Trusts relating to end of life care priorities in hospitals; and what assessment he has made of the adequacy of (a) compliance by hospitals with established end of life care priorities and (b) communication with family members and next of kin regarding end of life care decisions.

The Department does not hold central estimates of the number of complaints National Health Service trusts receive specifically relating to end‑of‑life care priorities in hospitals. Complaints are managed locally by NHS organisations in line with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, NHS Complaint Standards (2022), and Health and Care Act 2022, which set out the requirements for handling complaints in all NHS bodies. Anyone can raise concerns about NHS care, and trusts must investigate these in accordance with the regulations.NHS England sets out clear expectations for high‑quality end‑of‑life care through statutory guidance and service specifications for integrated care boards (ICBs) on commissioning palliative care and end‑of‑life care services. Compliance with established end‑of‑life care priorities is monitored through existing assurance mechanisms. The Care Quality Commission assesses whether trusts have effective systems in place to recognise deterioration, safeguard vulnerable adults, and provide safe, compassionate care at the end of life. NHS England also annually assesses ICBs on how well they discharge their statutory functions, including commissioning high‑quality palliative care and end‑of‑life care.We recognise that high-quality palliative care and end-of-life care should include the opportunity for individuals to discuss their wishes and preferences so that these can be taken fully into account in the provision of their future care, also known as advance care planning (ACP).NHS England has published Universal Principles for Advance Care Planning. These principles facilitate a consistent national approach to ACP in England. The principles focus on the importance of providing opportunities for a person and their family or carers to engage in meaningful discussions, led by the person concerned, which consider that person’s priorities and preferences, including place of care, when they are nearing the end of life.

What steps his Department is taking to ensure that clinicians in emergency and urgent care settings receive adequate training in the recognition and management of hamstring avulsion injuries.

Regulated healthcare professionals need to meet the standards of proficiency, conduct, and performance set by the relevant professional regulator, which are independent of the Government. It is the responsibility of individual employers to ensure their staff have appropriate access to ongoing training and professional development to provide safe and effective care.

If his Department will review information on the NHS website regarding hamstring injuries to ensure it adequately reflects the potential severity of hamstring avulsion injuries and the possible need for surgical intervention.

Decisions on the need for magnetic resonance imaging (MRI) scans in the case of hamstring avulsion injuries are clinically led. The Department has not made an assessment of the adequacy of the relevant guidance.The hamstring injury page on the NHS.UK website was recently reviewed against the latest clinical evidence and updated in July 2025. The current page does alert users to the potential for a hamstring injury to be severe and require surgery, and where and when to get medical help. NHS England routinely updates the NHS.UK website in line with clinical evidence to ensure individuals with a potential hamstring injury are provided with the latest clinical evidence.The Department is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including for MRI. NHS England is taking steps to support MRI services to remain resilient, effective, and able to meet growing demand. Over the past five years, significant capital investment has been deployed to strengthen service resilience, increase capacity, and improve patient access. This has included funding for new MRI assets, upgrading existing machines with MRI acceleration software, and supporting trusts in replacing failing or outdated systems.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26, some of which will deliver new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.

What assessment his Department has made of the adequacy of guidance for NHS trusts on the urgent provision of MRI scans for patients with hamstring avulsion injuries.

Decisions on the need for magnetic resonance imaging (MRI) scans in the case of hamstring avulsion injuries are clinically led. The Department has not made an assessment of the adequacy of the relevant guidance.The hamstring injury page on the NHS.UK website was recently reviewed against the latest clinical evidence and updated in July 2025. The current page does alert users to the potential for a hamstring injury to be severe and require surgery, and where and when to get medical help. NHS England routinely updates the NHS.UK website in line with clinical evidence to ensure individuals with a potential hamstring injury are provided with the latest clinical evidence.The Department is committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including for MRI. NHS England is taking steps to support MRI services to remain resilient, effective, and able to meet growing demand. Over the past five years, significant capital investment has been deployed to strengthen service resilience, increase capacity, and improve patient access. This has included funding for new MRI assets, upgrading existing machines with MRI acceleration software, and supporting trusts in replacing failing or outdated systems.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26, some of which will deliver new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.

What plans his Department has to increase MRI scanning capacity in the NHS.

We are committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services, including investment in new magnetic resonance imaging (MRI) scanners. This will speed up waiting times for tests, a crucial part of reducing overall waiting times and returning to the referral to treatment 18-week standard.The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. This includes £600 million in capital funding for diagnostics in 2025/26 to support delivery of the NHS performance standards. This funding will deliver new community diagnostic centres, including new MRI scanners, new scanners in acute hospital settings, as well as replacement of the oldest MRI scanners and MRI acceleration software.Further details and allocations will be set out in due course.

Whether his Department plans to review the amount of hours of training that newly qualified counsellors and psychotherapists have to complete before being eligible to work in the NHS.

It is the responsibility of individual employers to set any specific requirements for their roles and to ensure staff meet patient safety, clinical quality, and professional competence.

Whether his Department plans to a) make the Psychotherapeutic Counselling Core pilot training pathway permanent and b) increase the number of places available through the pathway.

The Psychotherapeutic Counselling Core training pathway is no longer a pilot and is a part of NHS England’s regular commissioning cycle for the education and training programmes. There are no plans to increase the number of training places on the Psychotherapeutic Counselling Core training pathway.

What steps he is taking to ensure parity of funding and service provision between physical health services and mental health services.

We are committed to giving mental health the same attention and focus as physical health. We know that, for people living with severe mental illness, life expectancy is 15 to 20 years shorter than that for the general population.As the Medium-Term Planning Framework makes clear, we need a new approach for mental health, to drive down waits, improve the quality of care, and increase productivity of mental health services. Funding is a key part of this. We have set out that over the next three years, integrated care boards will be required to meet the mental health investment standard by protecting mental health spending in real terms. In other words, rising in line with inflation from 2026/27.The 10-Year Health Plan sets out our vision for the neighbourhood health service. This is about bringing care into local communities, convening professionals into patient-centred teams, ending fragmentation, and abolishing the National Health Service default of ‘one size fits all’ care. Through six pilot sites we are testing 24/7 neighbourhood mental health centres. These provide round the clock, open-access to treatment and support for adults with severe mental health needs, and we are now looking to roll the model out more widely. The centres will work in close partnership with primary care to provide wraparound support for service users.

What assessment he has made of the adequacy of progress towards ensuring that all areas have a commissioned 24/7 community mental health crisis service; and what steps he is taking to support areas that have not yet been able to implement such provision.

While no such specific assessment has been made, integrated care boards, supported by regions, should maintain full 24/7 community mental health crisis coverage.To strengthen access to urgent mental health support, anyone in England experiencing a mental health crisis can now to speak to a trained National Health Service professional at any time of the day through a mental health option on NHS 111. This integrated service can give patients of all ages, including children, the chance to be listened to by a trained member of staff who can help direct them to the right place.There are currently six funded sites piloting the 24/7 neighbourhood mental health centre model, as well as 16 'associate sites' that are already proactively testing the model. These centres bring together a range of community mental health services under one roof, including crisis services and short-stay beds. The Government will make available capital funding of £473 million over four years to invest in new models, including 24/7 Neighbourhood Mental Health Centres, building on findings from the six pilots, and other capital projects such as Mental Health Emergency Departments and eliminating out-of-area placements.

Whether his Department has made a recent assessment of the potential impact of the repairs backlog at Stepping Hill Hospital on patient care and waiting times; and if he will make an estimate of the potential cost to the public purse of meeting those repair costs in the next three years.

We have inherited a broken National Health Service, with many hospitals in a state of disrepair, and patients unable to access the care they need. We recognise that hospitals across the country, including Stepping Hill, have challenging and poor-quality infrastructure. Repairing and rebuilding our healthcare estate is a vital part of our ambition to create an NHS that is fit for the future through our 10-Year Health Plan.We are working to rebuild the health service. We are backing the NHS with over £4 billion in operational capital in 2025/26, with a further £16.9 billion to be allocated to integrated care boards (ICBs) and providers over the following years. Providers have also been given further five-year operational capital planning assumptions, covering 2030/31 to 2034-35, allowing them to plan longer term with confidence and accelerate investment decisions aligned to local priorities, including repairs and maintenance.In addition, we will provide £30 billion across five years, namely 2025/26 to 2029/30, in day-to-day maintenance and repair of the NHS estate, with a further five years of funding certainty for estates maintenance as set out in the 10 Year Infrastructure Plan. Within this, the Estates Safety Fund, established in 2025/26, will continue, providing £6.75 billion investment over the next nine years to target the most critical building repairs. The £2.5 million allocated to Stepping Hill hospital from the Estates Safety Fund in 2025/26 is the first step in addressing the repairs backlog at Stepping Hill Hospital.

How many of the places intended to be filled by the Government's Golden Hello Scheme for NHS dentists have been, and what work the Government will be doing with local ICBs to ensure that they hit more of their targets.

Integrated care boards (ICBs) are continuing to recruit dentists through the Golden Hello scheme. The scheme offers a £20,000 recruitment incentive payment to dentists to work in those areas that need them most. The scheme remains a national priority.Golden Hello data will be published this year and will consist of data showing the regional distribution of the original allocation of posts and the number of posts recruited to at both a national and regional level.

What steps his Department is taking to reimburse or provide financial support to families of dementia patients who are required to pay for care while local authorities consider their applications for support.

Local authorities are responsible for assessing individuals’ care and support needs and, where eligible, for meeting those needs, as set out in the Care Act 2014.The Care and Support Statutory Guidance states that “an assessment should be carried out over an appropriate and reasonable timescale taking into account the urgency of needs and a consideration of any fluctuation in those needs”. In addition, under Section 19 of the Care Act 2014, local authorities have powers to meet urgent needs for care and support without first carrying out a needs assessment or financial assessment.There is no legal entitlement to reimbursement for care costs incurred prior to a local authority decision.Individuals who are concerned about delays or decisions may raise these through local authority complaints processes or with the Local Government and Social Care Ombudsman.

What assessment he has made of the effectiveness of current NHS strategies to prevent eating disorders, particularly among children and young people; and what steps he is taking to strengthen early intervention and prevention services.

NHS England will shortly publish refreshed guidance on children and young people’s eating disorders. This guidance strengthens the focus on early identification and intervention across the whole care pathway, including in settings such as schools and primary care, to support prevention and timely access to help. It places particular emphasis on high-quality community provision, while ensuring that children and young people can access specialist support swiftly as soon as an eating disorder is suspected.Since 2016, investment in children and young people’s community eating disorder services has increased every year. This includes an additional £54 million per year from 2023/24, which continues to enhance the capacity and capability of community eating disorder teams to deliver early intervention, evidence-based treatment, and ongoing support for all children and young people, including boys and young men.Integrated care boards (ICBs) are responsible for commissioning eating disorder pathways for their local populations. In doing so, ICBs are expected to assess and respond to the needs of their local communities and to ensure services are provided equitably, including that diagnosis, treatment pathways, and clinical support are appropriate and accessible for all patients. This includes maintaining effective transitions from inpatient care into community services, with robust follow-up and ongoing support to reduce the risk of deterioration following discharge.

What assessment he has made of whether eating disorder services adequately meet the needs of boys and young men; and what steps he is taking to ensure that diagnosis, treatment pathways and clinical support are appropriate and accessible for male patients.

NHS England will shortly publish refreshed guidance on children and young people’s eating disorders. This guidance strengthens the focus on early identification and intervention across the whole care pathway, including in settings such as schools and primary care, to support prevention and timely access to help. It places particular emphasis on high-quality community provision, while ensuring that children and young people can access specialist support swiftly as soon as an eating disorder is suspected.Since 2016, investment in children and young people’s community eating disorder services has increased every year. This includes an additional £54 million per year from 2023/24, which continues to enhance the capacity and capability of community eating disorder teams to deliver early intervention, evidence-based treatment, and ongoing support for all children and young people, including boys and young men.Integrated care boards (ICBs) are responsible for commissioning eating disorder pathways for their local populations. In doing so, ICBs are expected to assess and respond to the needs of their local communities and to ensure services are provided equitably, including that diagnosis, treatment pathways, and clinical support are appropriate and accessible for all patients. This includes maintaining effective transitions from inpatient care into community services, with robust follow-up and ongoing support to reduce the risk of deterioration following discharge.

What assessment he has made of the continuity of care for children and young people discharged from inpatient eating disorder units into community settings; and what steps he is taking to prevent deterioration in patients’ conditions following discharge.

NHS England will shortly publish refreshed guidance on children and young people’s eating disorders. This guidance strengthens the focus on early identification and intervention across the whole care pathway, including in settings such as schools and primary care, to support prevention and timely access to help. It places particular emphasis on high-quality community provision, while ensuring that children and young people can access specialist support swiftly as soon as an eating disorder is suspected.Since 2016, investment in children and young people’s community eating disorder services has increased every year. This includes an additional £54 million per year from 2023/24, which continues to enhance the capacity and capability of community eating disorder teams to deliver early intervention, evidence-based treatment, and ongoing support for all children and young people, including boys and young men.Integrated care boards (ICBs) are responsible for commissioning eating disorder pathways for their local populations. In doing so, ICBs are expected to assess and respond to the needs of their local communities and to ensure services are provided equitably, including that diagnosis, treatment pathways, and clinical support are appropriate and accessible for all patients. This includes maintaining effective transitions from inpatient care into community services, with robust follow-up and ongoing support to reduce the risk of deterioration following discharge.

What assessment he has made of the potential impact of neurology waiting times on patients; and what steps his Department is taking to support NHS trusts in reducing routine neurology backlogs.

The Department recognises that long waits for neurology appointments can have a significant impact on patients, including delayed diagnosis, prolonged uncertainty, and potential deterioration in health and quality of life. Neurological conditions are often complex and require timely specialist input to prevent complications and support effective management. To address these challenges, the Government and NHS England are taking a range of steps to reduce waiting times and improve access to care.Our Elective Reform Plan sets a clear target to return to the National Health Service constitutional standard that 92% of patients start consultant-led treatment within 18 weeks of referral by March 2029. We are investing in additional capacity to deliver appointments to help bring lists and waiting times down. The plan sets out the specific productivity and reform efforts needed to return to the constitutional standard.Initiatives such as Getting It Right First Time and RightCare are supporting systems to redesign neurology pathways, reduce unwarranted variation, and improve outpatient flow. These programmes provide evidence-based recommendations for integrated care models and better workforce planning.NHS England’s Standardising Community Health Services guidance asks integrated care boards to include community neurorehabilitation as a core component of local services, helping to shift care closer to home and reduce pressure on hospital-based neurology clinics.The 10-Year Health Plan sets out a transformed vision for elective care by 2035, where the majority of interactions no longer take place in a hospital building, instead happening virtually or via neighbourhood services. Planned care will be more efficient, timely, and effective, and will put control in the hands of patients.We are also committed to transforming and expanding diagnostic services and speeding up waiting times for tests. This includes investment in new and expanded community diagnostic centres, which are supporting a key Government priority to shift care from the hospital to the community, which offer the tests needed to support diagnosis of suspected neurological conditions.The Government’s forthcoming 10 Year Workforce Plan will set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it.These actions form part of a wider strategy to improve access, reduce backlogs, and deliver high-quality neurological care across England.

What steps are being taken to support GP practices in providing specialist in-house coil clinics, in the content of levels of staffing, clinic space, equipment and stock availability; and what steps he is taking to reduce waiting times for coil fittings.

The Government remains committed to ensuring equitable access to a range of contraceptive methods, including the coil.Under the GP Contract, contraceptive services are part of the essential services that practices must provide, either directly or by making arrangements for their patients to access them. Integrated care boards (ICBs) may commission GPs to offer long acting reversible contraception, such as the contraceptive coil, as an enhanced service to their local population, in addition to the service provided through the GP Contract. It is for ICBs to decide on commissioning arrangements for their area based on an assessment of local need. Information on levels of staffing, clinic space, equipment and stock availability, and waiting times for coil fittings are not held centrally.

What steps he is taking to ensure that patients receiving (a) ADHD and (b) autism treatment through the Right to Choose pathway receive safe and uninterrupted care when GPs are unable to accept shared care arrangements.

Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as prescription of medication, over to the patient’s general practitioner (GP). The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs are not contractually obliged to enter into shared care agreements, and GPs may decline such requests on clinical or capacity grounds. The GMC has also issued guidance to help GPs decide whether to accept shared care responsibilities.In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors to determine whether it is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes being satisfied that any prescriptions or referrals for treatment are clinically appropriate.On initiating a treatment, the specialist clinician must follow GMC guidance that if continuation of the treatment is dependent on shared care, then an agreement with the GP must be in place before the treatment is started. If a shared care agreement is not in place, the responsibility for ongoing prescribing remains with the specialist clinician, and this applies to both NHS and private medical care.It is the responsibility of integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism services and support, in line with relevant National Institute for Health and Care Excellence guidelines.

Whether his Department has considered a national workforce strategy to retain ADHD and autism clinicians within NHS services.

The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan.The 10 Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. We are working through how the plan will articulate the changes for different professional groups.

What assessment he has made of the potential merits of a joined-up continence care pathway between the NHS, local authorities and care home providers to ensure residents receive appropriate and personalised continence support.

The 10-Year Health Plan will shift care from hospital to community, and will thereby help to drive more joint working in neighborhoods between primary care, pharmacies, community health care, and social care to help people to manage continence at home, helping them to have access to the right self-care, the right professional support so they aren’t passed from service to service, and reducing their need for emergency admissions to hospital. National Institute for Health and Care Excellence guidance on continence care recommends commissioners and providers deliver high quality management of continence care provision delivered in an integrated way.