Written questions by Smart.

What assessment he has made of the potential impact of issues with the reconciliation of pension contributions by Capita on GPs.

General practitioners (GPs) are required to submit either a type one or type two annual certificate each year to Primary Care Support England (PCSE). Each certificate received by PCSE is reconciled on an individual basis, and the GP’s record is updated accordingly. Where the information cannot be reconciled, or the information is incomplete, PCSE will return the certificate to the GP outlining what information is required.NHS England regularly monitors the number of outstanding certificates and missing data, working closely with PCSE to resolve issues. In addition, NHS England works closely with the British Medical Association and NHS Pensions to manage complaints and proactively resolve issues. NHS England also monitors PCSE’s performance on a monthly basis against contractual performance targets.Supporting GPs to accurately submit current and historic type one or type two annual certificates remains a priority for NHS England and PCSE. Since the PCSE Online solution for submitting type one and type two certificates electronically went live in 2021, PCSE has developed user guides and held webinars to educate GPs on how to complete forms accurately.

Whether his Department is taking steps to hold Capita accountable where it fails to provide GPs with accurate annual pension statements under the Primary Care Support England scheme.

Capita, who delivers Primary Care Support England (PCSE), does not issue pension statements to general practitioners (GPs), as this is the responsibility of NHS Pensions, which is managed by the NHS Business Services Authority (NHS BSA). PCSE updates GP pension records once the appropriate type one or type two annual certificate is submitted to PCSE for processing by the GP.In order for NHS Pensions to generate an annual pension benefits statement, it is necessary for the GP’s pension record to be up to date, with no missing annual certificate for prior years. NHS England works closely with PCSE and NHS Pensions to ensure that GPs are supported, through a series of webinars and guidance documents, to submit accurate information in a timely manner. NHS England tracks PCSE’s performance on a monthly basis against contractual performance targets. NHS England continues to work with PCSE, NHS Pensions, and GP representative bodies to rectify historical gaps in GP records.More generally, the importance of checking PCSE Online to ensure that all required type one or type two forms are showing as approved, and to submit certificates if there are any missing years to get records up to date, is highlighted in communications to GPs.

Whether his Department has plans to issue updated guidance on the placement of dementia patients in hospital wards.

The National Institute for Health and Care Excellence’s (NICE) guidance on dementia states which aspects of care should be expected to ensure quality dementia care in hospital. This includes appropriate admission to hospital, comprehensive assessments, and personal history taking. Further information on the NICE’s dementia guidance is available at the following link:https://www.nice.org.uk/guidance/ng97The NICE’s guidance on the transition between inpatient hospital settings and community or care home settings for adults with social care needs covers the transition between inpatient hospital settings and community or care homes for adults with social care needs. Further information on the NICE’s transition guidance is available at the following link:https://www.nice.org.uk/guidance/ng27The NICE’s guidance will be reviewed if there is new evidence that is likely to change the recommendations. The 10-Year Health Plan will address the challenges diagnosed by Lord Darzi and set the vision for what good joined-up care looks like for people with a combination of complex health and care needs. It will set out how we support and enable health and social care services to work together better to provide that joined-up care. The Government is launching an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service.To improve care for patients with dementia, NHS England's RightCare team has refreshed the RightCare Dementia Scenario. The scenario works through the dementia well pathway journey, from diagnosing well through to dying well, detailing optimal and suboptimal approaches, with associated costings for each.

What steps his Department is taking to reduce delays in transferring dementia patients from hospitals to social care settings.

Almost one million people in the United Kingdom are living with dementia, and that figure is expected to rise. Each of those people, alongside their friends, families and carers, have their own unique and important story of living with dementia, and this government wants a society where every person with dementia receives high-quality, compassionate care from diagnosis through to the end of life.We are working to reduce delayed discharges by improving local partnership working between the National Health Service and social care systems, ensuring that people are not stuck in hospital beds when they are well enough to go home.In December 2024, working with the Local Government Association and NHS England, we published a High Impact Change Model for improving the timely and effective discharge of people with dementia or delirium into the community. This resource offers practical guidance and a set of recommended actions that systems should consider for optimising the discharge process and deliver best practice for an individual’s journey to, during and following discharge. The model is available at the following link:https://www.local.gov.uk/our-support/partners-care-and-health/better-care-fund-support-programme-2023-25/high-impact-change

What steps his Department is taking to ensure NHS hospital staff receive adequate (a) training and (b) support to manage dementia patients in general hospital wards.

Employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver the appropriate treatment for patients. Individual trusts are responsible for ensuring that their staff are trained to carry out their role, and for investing in the future of their staff through providing continuing professional development funding.The required training needs are set out in the Dementia Training Standards Framework, commissioned and funded by the Department and developed in collaboration with the sector, which is available at the following link:https://www.skillsforhealth.org.uk/info-hub/dementia-2015-updated-2018/The framework sets out the essential knowledge, skills, and expected learning outcomes applicable across the health and care spectrum. The National Institute for Health and Care Excellence has also issued guidance on Assessment, Management and Support for People Living With Dementia, which covers staff training and education, and which is available at the following link:https://www.nice.org.uk/guidance/ng97/chapter/Recommendations#staff-training-and-education

With reference to his Oral Statement of 11 December 2024 on Puberty-suppressing Hormones, Official Report, column 914-916, whether the clinical trial into the use of puberty suppressing hormones for gender incongruence will begin early this year; and when his Department intends to update parents and young people on the (a) timetable and (b) eligibility of the clinical trial.

The PATHWAYS study proposal, including the clinical trial of puberty-suppressing hormones, is going through all the usual review and approval stages. These include an independent academic peer review and consideration by the National Institute for Health and Care Research’s funding committee. The study will need to secure full ethical approval before it can be set up and recruitment can open. The design of the study, including the timetable and eligibility criteria, will be finalised as part of the approvals process. It is planned to commence this year. Subject to the study achieving the necessary approvals, the study protocol will be made available in the public domain, as is usual for publicly funded studies.

What steps his Department is taking to ensure that the process of issuing death certificates following the change to the responsibilities of medical examiners on 9 September 2024 does not lead to undue delays in families being able to arrange funerals.

The Government is monitoring the impact of the death certification reforms, including the Medical Certificate of Cause of Death Regulations 2024, which came into legal effect on 9 September 2024. Early data indicates the median time taken to register a death appears to have risen by one day, from seven days to eight days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The average time taken to register has increased further over the recent Christmas weeks, but this was expected given increases are observed during this period every year; the average is expected to decrease again as more data becomes available for January and February 2025. The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days. We note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.The core purposes of the death certification reforms are to introduce scrutiny of the cause of death to detect and deter malpractice, to improve reporting, and crucially to put the bereaved at the centre of the process by offering a conversation with the medical examiner about the cause of death. The expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case.

When the Minister for Health and Secondary Care plans to respond to the correspondence of 6 November 2024 from the hon. Member for Hazel Grove on funding for Stepping Hill Hospital.

I replied to the hon. Member on 29 January 2025.

What steps his Department is taking to increase the supply of semaglutide in Hazel Grove constituency.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within individual constituencies is not held centrally. The Department is not aware of any current supply issues for semaglutide. Ozempic and Wegovy, injectable forms of semaglutide, are currently available, and Rybelsus, an oral tablet containing semaglutide, is also available. The Department continues to monitor the situation, ensuring that medicines remain available for new patients with type 2 diabetes, as well as those unable to obtain their existing treatment. The General Pharmaceutical Council, General Medical Council, Health and Care Professions Council, Nursing and Midwifery Council, and Pharmaceutical Society of Northern Ireland have also issued a joint statement stressing the importance of health and care professionals meeting regulatory standards in relation to these medicines. The guidance is clear, that medications licensed to treat type 2 diabetes should not be prescribed for weight loss, except where specifically licenced for this use. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

What steps his Department is taking to (a) support and (b) encourage Integrated Care Boards to prescribe semaglutide for weight management.

Obesity medicines can be effective for some patients living with obesity when prescribed alongside diet, physical activity, and behavioural support. Exactly what is most appropriate for an individual is down to health care professionals to advise, in discussion with patients, and considering relevant clinical guidance.The National Institute for Health and Care Excellence recommended semaglutide as an option for weight management, alongside a reduced-calorie diet and increased physical activity, for adults that meet the eligibility criteria, and only if it is used within a specialist weight management service providing multidisciplinary management of overweight or obesity.Integrated care boards (ICBs) are responsible for arranging the provision of health services within their area in line with local priorities, considering population need and relevant guidance. This includes the commissioning of NHS specialist weight management services.National Health Service organisations, including ICBs, are continuing to look at the best way to manage access to treatments for obesity.

What steps his Department is taking to (a) encourage NHS trusts in Greater Manchester to participate in the Early Access Programme for Givinostat and (b) to help tackle barriers to participation.

NHS England does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies.Participation in the Early Access Programme (EAP) for givinostat, which must be through one of the 23 NorthStar Centres in the United Kingdom, is decided at an individual National Health Service trust level although there is general advice that trusts should engage with the relevant commissioner if they choose to participate. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation. Under the EAP, givinostat is free to both patients taking part in it and to the NHS, but the trusts must still cover the cost of administering it to patients. Only Duchenne muscular dystrophy clinicians can make requests for givinostat for their patients. Decisions are made on a case-by-case basis for individual named patients aligned to eligibility criteria.NHS England hopes that all NHS trusts, including in Greater Manchester, who receive a request from a NorthStar Centre to provide givinostat to an eligible patient approve this request. NHS England will work with partners to ensure that Trusts understand the urgent need to make access possible for eligible patient.

Whether he plans to include Annatto (E160b) on the list of allergens that must be labelled under UK food labelling regulations.

There are many potential food ingredients that may cause an allergic reaction to sensitised people. The current 14 regulated allergens are recognised as being the most common and potent allergens of public health concern across Europe.   Further information is available at the following link:https://www.food.gov.uk/business-guidance/allergen-guidance-for-food-businessesThe prevalence of allergy to the additive Annatto (E160b) is currently unknown in the United Kingdom. The Food Standards Agency (FSA) is currently working with the British Society for Allergy and Clinical Immunology and other stakeholders on gathering information on hidden and emerging food allergens which will help in assessing the need for further research and work in this area. If further information is received on the prevalence of Annatto as an allergy we will review this evidence. The FSA continues to monitor the situation closely but has no current recommendations to Ministers on amending the list of 14 regulated allergens.The FSA continues to work to make it easier for people with food hypersensitivities, namely allergies, intolerances, and coeliac disease, to have access to clear and accurate information which is a fundamental part of their work. Their research is available at the following link:https://www.food.gov.uk/research/food-hypersensitivity

What steps his Department is taking to improve the diagnosis and recognition of Lyme Disease.

I refer the hon. Member to the answer I gave to the hon. Member for South Cambridgeshire on 12 November 2024 to Question 13156.

What his planned timetable is to spend the additional funding allocated for new radiotherapy machines on 28 October 2024.

The £70 million investment in new radiotherapy machines will ensure that the most advanced treatment is available to patients. Following publication of the 10-Year Health Plan, we will publish the new national cancer plan, which will include further detai...

What steps his Department is taking to ensure the new additional funding for new radiotherapy machines aligns with the (a) NHS Long-Term Plan and (b) the upcoming 10-year cancer strategy.

The £70 million investment in new radiotherapy machines will ensure that the most advanced treatment is available to patients. Following publication of the 10-Year Health Plan, we will publish the new national cancer plan, which will include further detai...

If he will make it his policy to create a cross-governmental strategy for the prevention of ill health that would include measures on tackling (a) health and (b) other lifestyle factors that affect

As part of the Government’s health mission, we will shift from sickness to prevention, to tackle ill health, prevent premature deaths, and build a fairer United Kingdom where everyone lives longer, healthier lives.We have committed to developing a 10-year...

What steps his Department is taking to raise (a) public and (b) professional awareness of (i) inflammatory bowel disease and (ii) other unseen disabilities in the context of access to (A) healthcar

NHS England’s Getting It Right First Time Programme on gastroenterology aims to reduce variations in care, increase early diagnosis and proactive management of Crohn’s disease and colitis, and increase access to inflammatory bowel disease (IBD) specialist...

What steps his Department is taking to improve (a) support and (b) care pathways in the NHS for people diagnosed with inflammatory bowel disease.

NHS England’s National Bladder and Bowel Health Project is delivering better care for people with inflammatory bowel disease (IBD), with a focus on developing best practice clinical pathways. NHS England commissions specialised colorectal services nationa...

What steps his Department is taking to increase the number of dentists in Hazel Grove 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 de...

What steps his Department is taking to improve the (a) diagnosis and (b) treatment of (i) endometriosis and (ii) adenomyosis.

The Government is committed to prioritising women’s health and improving the diagnosis, treatment, and ongoing care for gynaecological conditions. National Institute for Health and Care Excellence (NICE) guidelines support healthcare professionals to diag...