Written questions by Evans.

With reference to the oral contribution by the Minister for Care of 13 January 2025, Official Report, column 128, what his planned timetable is for discussions between his Department and NHS England on the distribution of hospice funding.

We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices to ensure they have the best physical environment for care. We are working at great pace to get this year’s funding to hospices as soon as possible, including having regular discussions involving NHS England and Hospice UK. We are currently finalising the delivery mechanisms and are pleased that Hospice UK stands ready to distribute the money to local hospices throughout England.We are also providing an additional £26 million of revenue funding to support children and young people’s hospices. We are aware that the shift to an integrated care board (ICB) transacted model for 2024/25 was not as smooth a transition as we would have hoped. We are working closely with NHS England so planning for 2025/26 is improved.NHS England is currently making decisions on the allocation and administration mechanisms for the £26 million of revenue funding for children and young people’s hospices in 2025/26 and hopes to communicate plans to the sector later this month.Although palliative and end of life care is mostly provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each area. Therefore, there are no current plans to undertake a review of the distribution of hospice funding.Neither the Department nor NHS England believe that publishing a consultation on the distribution of hospice funding is necessary, but both organisations are in regular discussions with key hospice sector stakeholders on this issue.Earlier this month, I met the major palliative and end of life care, including hospice, stakeholders when long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

With reference to the oral contribution by the Minister for Care of 13 January 2025, Official Report, column 128, if he will undertake a review of the distribution of hospice funding.

We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices to ensure they have the best physical environment for care. We are working at great pace to get this year’s funding to hospices as soon as possible, including having regular discussions involving NHS England and Hospice UK. We are currently finalising the delivery mechanisms and are pleased that Hospice UK stands ready to distribute the money to local hospices throughout England.We are also providing an additional £26 million of revenue funding to support children and young people’s hospices. We are aware that the shift to an integrated care board (ICB) transacted model for 2024/25 was not as smooth a transition as we would have hoped. We are working closely with NHS England so planning for 2025/26 is improved.NHS England is currently making decisions on the allocation and administration mechanisms for the £26 million of revenue funding for children and young people’s hospices in 2025/26 and hopes to communicate plans to the sector later this month.Although palliative and end of life care is mostly provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each area. Therefore, there are no current plans to undertake a review of the distribution of hospice funding.Neither the Department nor NHS England believe that publishing a consultation on the distribution of hospice funding is necessary, but both organisations are in regular discussions with key hospice sector stakeholders on this issue.Earlier this month, I met the major palliative and end of life care, including hospice, stakeholders when long-term sector sustainability, within the context of our 10-Year Health Plan, was discussed at length.

If he will have discussions with (a) NHS England and (b) integrated care boards on the adequacy of NICE guidelines on the management of cerebral palsy in people under 25 years old with no cognitive impairment.

The National Institute for Health and Care Excellence’s (NICE) guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive public and stakeholder engagement. They represent best practice and should be taken fully into account by healthcare professionals in the care and treatment of their patients.NICE is responsible for making decisions on updates to its guidelines and keeps its guidelines under surveillance to ensure that they reflect developments in the evidence base. NICE is not due to update its guideline on the assessment and management of cerebral palsy in people under 25 years old at the current time. If relevant new evidence emerges, NICE will follow its processes and consider whether any update is needed to the current guideline.To support those people under 25 years old who are diagnosed with cerebral palsy, NHS England has worked with key stakeholder organisations, including children and young people, and their families and carers, to develop a framework targeted to integrated care systems to be used a supportive tool to aid the commissioning of high-quality services for children and young people with cerebral palsy, including those in the transition period to adult services.NHS England’s Getting It Right First Time (GIRFT) Programme aims to improve care for people with neurological conditions in England, including those with cerebral palsy, by reducing variation and delivering care more equitably across the country.  The GIRFT National Speciality Report provided the opportunity to share successful initiatives between trusts to improve patient services nationally.

If he will make an assessment of the adequacy of the care continuity for individuals with Cerebral Palsy with no cognative impairment moving from childrens care pathways to adult support networks.

There are no current plans to make such an assessment. The National Institute for Health and Care Excellence’s (NICE) guidance on cerebral palsy in under 25 year olds, guidance code NG62, includes recommendations on the transition from children to adult services and stresses the requirement to ensure that an individual's developmental, social, and health needs are addressed when planning and delivering the transition. The guidance also sets out key considerations to be made around transition planning, including: clear pathways involving both the young person's general practitioner and named clinicians in adult services; ensuring sufficient training for the professionals involved in the care; clear communication at each point of transition; and a named worker to support continuity of care.Further NICE guidance on cerebral palsy in adults, code NG119, recommends that adults with cerebral palsy should be offered an annual review of their clinical and functional needs, as part of ongoing care, carried out by a healthcare professional with expertise in neurodisabilities.NHS England has worked with key stakeholder organisations, including children and young people, and their families and carers, to develop a framework targeted at integrated care systems to be used as a supportive tool to aid in the commissioning of high-quality services for children and young people with cerebral palsy, including those in the transition period to adult services.In the NHS Long Term Plan, NHS England committed to delivering a service model for zero to 25-year-olds to improve young people’s experiences and health outcomes. To aid implementation of this model, the Children and Young People’s Transformation programme collaborated with key partners to develop national guidance on how the National Health Service can better support young people’s transfer into adolescent and adult services. The guidance is due to be published shortly and will be hosted on the NHS England website. The policy aligns with existing NICE guidelines, code NG43, and outlines the principles and steps of a zero to 25-year-old service model, along with best practice examples from across the country.The Children and Young People’s Transformation programme is working with the NHS Youth Forum to gather the experiences and ideas of young people on adolescent healthcare. The forum will develop recommendations to inform future policies on healthcare transition, including how to deliver developmentally appropriate and person-centred care.

With reference to the publication by NHS England entitled Reforming elective care for patients, published on 6 January 2025, whether he has had recent discussions with General Practitioners on the potential impact of changes to the legal framework on advice and guidance pathways.

The Department and NHS England started consultation with the General Practitioners Committee in England, of the British Medical Association, on the 2025/26 GP Contract on 19 December, and will consider all proposed policy changes, including advice and guidance arrangements. Final changes will be announced in the usual way, following the close of the consultation in 2025.

With reference to the publication by NHS England entitled Reforming elective care for patients, published on 6 January 2025, whether the fee paid to GPs for providing advice and guidance with hospital specialists will cover the costs of any subsequent follow up request for further guidance.

Advice and Guidance services enhance two-way communication between clinical colleagues in primary and secondary care. The Elective Reform Plan has committed to ensuring that general practitioners (GPs) will receive £20 per Advice and Guidance request, to recognise the importance of their role in ensuring patients receive the right care, in the right clinical setting.Each Advice and Guidance request will be funded at £20, which is to cover any back and forth required between a GP and a hospital specialist to reach a resolution, and this may be one interaction or several dependant interactions.

When he plans to publish the call for evidence for the men’s health strategy; and what estimate he has made of when the men’s health strategy will be published.

On 28 November 2024, my Rt Hon. Friend, the Secretary of State for Health and Social Care announced plans for England’s first Men’s Health Strategy, to be delivered this year.The strategy will be informed by a call for evidence which will be launched shortly. The call for evidence will seek views on what is currently working and what more needs to be done to support the health of all men.

If he will provide an update on negotiations with NHS England on the Community Pharmacy Contractual Framework.

We have been clear that we want to work with the sector on a service fit for the future. Now that the Budget for the Government has been set, we will shortly be resuming our consultation with Community Pharmacy England regarding the funding arrangements for community pharmacy.

If he will make an assessment of the potential merits of referring the NHS Business Services Authority to the Pensions Regulator, in the context of concerns with the annual allowance.

The NHS Business Services Authority has proactively informed the regulator of an error in the pension growth calculations which affects 2023/24 Pension Savings Statements.

If he will meet (a) NHS England, (b) MHRA and (c) bodies supporting people affected by (i) Post-Finasteride Syndrome and (ii) Post-SSRI Sexual Dysfunction following the use of anti-depressant medication to discuss that issue.

Ministers meet regularly with external stakeholders on a variety of issues, including with organisations such as NHS England, the Medicines and Healthcare products Regulatory Agency (MHRA), and bodies representing patients affected by medicines and medical devices.The MHRA, as the regulator for medicines and medical devices, ensures that appropriate information is provided for each medicine on the United Kingdom’s market. The MHRA is currently reviewing the existing warnings in relation to sexual dysfunction which may continue after stopping anti-depressant medication, and recently completed an extensive safety review of finasteride and persistent sexual dysfunction, including after stopping treatment with finasteride.

What assessment he has made of the potential implications for his policies of the recent advice from the British Medical Association to stop engaging with advice and guidance pathways.

The Government is committed to delivering on its commitment in the recently published Elective Reform Plan to increase the use of Advice and Guidance by general practitioners (GPs), where appropriate, to support them to deliver high-quality patient care. The plan commits to paying GPs £20 per Advice and Guidance request in recognition of the fact that whilst it is a clinically helpful when used in the right circumstances, it can be time consuming.The consultation on the 2025/26 GP Contract has started with the General Practitioners Committee in England, of the British Medical Association, and a range of proposals will be considered, including Advice and Guidance arrangements. Ensuring Advice and Guidance arrangements are agreed as part of GP Contract negotiations is fundamental to ensuring that patients receive the right care, in the right clinical setting.

Whether he has made an estimate of the potential (a) savings to the NHS, (b) impact on waiting times and (c) impact on the workload of GPs of proposals to pay GPs £20 per request for undertaking advice and guidance with hospital specialists.

Advice and Guidance services enhance two-way communication between clinicians in primary and secondary care, with a view to ensuring patients receive the right care, in the right clinical setting. The Elective Reform Plan has committed to ensuring general practitioners will receive £20 per Advice and Guidance request, to recognise the importance of the role that they play in the delivery of this important service.The Government has not made a standalone estimate of the potential savings to the National Health Service. This is not a new policy. Advice and Guidance has been shown to be successful in reducing demand on elective care by diverting potential referrals, where specialist advice determines that the most appropriate setting for care is in primary or community care. Approximately half of Advice and Guidance requests were diverted in 2023/24. Where advice from a specialist results in a patient being treated in a primary or community care setting instead of a referral to the waiting list, patients should be seen sooner, in a suitable setting closer to home, with the right course of action, benefiting from specialist input.

Whether his Department has made an assessment of the potential implications for his policies of comparative data for GPs undertaking advice and guidance with hospital specialists in different (a) geographical areas and (b) medical specialisms.

The Elective Reform plan commits to expanding the use of Advice and Guidance to ensure two-way communication between general practitioners (GPs) and hospital specialists, and ensure more patients are seen in the right clinical setting.Officials routinely review data on the variation in performance and delivery of interventions to reduce the waiting list. It is recognised that variation in the use of Advice and Guidance by specialty or within specialties, based on the local patient population, is to be expected. The Elective Reform Plan commits to actions to spread effective practices and address unwarranted variation, including in the uptake of Advice and Guidance, and will focus on the specialties where it demonstrates the most value to clinicians and to patients.In order to optimise the use of Advice and Guidance for both GPs and hospital specialists, the Elective Reform plan commits to providing access to new metrics and dashboards on the Model Health System, and to providing and regularly updating resources on referral optimisation, as well as the NHS England Getting It Right First Time team’s Advice and Guidance toolkits and templates.

What discussions he has had with NHS England on which (a) straight-to-test pathways Community Diagnostic Centres and (b) hospital-based diagnostic services will be used to (i) develop and (ii) deliver its plan to reform elective care.

Currently, the waiting list stands at 7.48 million patient pathways, with over 6 million people waiting. As set out in the Plan for Change, we will ensure that 92% of patients return to waiting no longer than 18 weeks from Referral to Treatment (RTT) by March 2029, a standard which has not been met consistently since September 2015.The Elective Reform Plan, published in January 2025, sets out an expectation that performance will increase from the current 58%, as of December 2024, to 65% by March 2026, with every trust expected to deliver a minimum 5% improvement by March 2026. The plan sets out the breadth of actions necessary to deliver on the RTT standard, including the efforts which will improve productivity, reform the system, and improve patient experience.The plan announced that the integrated care boards will make optimal use of the new diagnostic capacity by implementing the new standards for Community Diagnostic Centres (CDCs), in particular, increasing direct referrals and rolling out at least 10 straight-to-test pathways by March 2026.The Department has, and continues to hold, discussions with NHS England on the delivery of the plan, including ensuring that at least 10 straight-to-test pathways are fully developed and in place by March 2026, and will set out further detail at the earliest opportunity. Both CDC and hospital-based diagnostic services will be integral to the delivery of the Elective Reform Plan.

Whether his Department has made an assessment of the potential implications for his policies of alleged errors made by the NHS Business Service Authority on (a) doctors pensions saving statements and (b) the annual allowance.

The Department recognises that the service received by impacted individuals was not acceptable and will negatively impact their personal pension tax affairs. The Department became aware of a calculation error in 2023/24 Pension Savings Statements issued by the NHS Business Services Authority (NHSBSA) on 6 January 2025. NHSBSA is working with the Department and the British Medical Association to understand the impact on individuals, to rectify the issue and provide guidance and support with their next steps.

Whether he has had recent discussions with the British Medical Association on proposals to pay GPs £20 per request for undertaking advice and guidance with hospital specialists.

In the Elective Reform Plan, the Government has proposed a £20 payment to general practitioners (GPs) per advice and guidance request. We expect this to increase the usage of advice and guidance, and help patients receive the care they need in primary and community settings, instead of being added to the elective waiting list. This funding will help deliver up to four million advice requests from GPs in 2025/26, up from 2.4 million in 2023/24, which we expect could increase diversions from elective care from 1.2 million in 2023/24 to two million in 2025/26. We are consulting with the General Practitioners Committee in England, of the British Medical Association, on the 2025/26 GP Contract, and will consider a range of proposed policy changes, including advice and guidance. These will be announced in the usual way following the close of the consultation in 2025.

What recent discussions he has had with (a) NHS England and (b) social care providers on expanding opportunities for social prescribing.

The Department and NHS England work closely together to deliver the social prescribing work programme.I met with representatives of the National Academy for Social Prescribing (NASP) on 13 January, a key stakeholder in this field. At the meeting, I confirmed that the Department recognises the value of social prescribing for addressing the wider determinants of health. The NASP shared reports on the evidence for social prescribing and future opportunities for the development of work that they have identified.

What estimate his Department has made of the size of the backlog of Remedial Pensions Savings Statements currently outstanding by the NHS Business Services Authority.

The Department understands that approximately 135,000 NHS Pension Scheme members may require a remedial pension savings statement as part of their remedy to the discrimination identified by the McCloud judgment. More than 70,000 statements have been issued to date, with approximately another 60,000 individuals still to be contacted. The Department understands the NHS Business Services Authority (NHSBSA) will issue the majority of these by the end of February 2025.The Department became aware of a calculation error in 2023/24 Pension Savings Statements issued by NHSBSA on 6 January 2025, and is working with the NHSBSA to ensure this is quickly rectified.

Whether he has had recent discussions with (a) NHS England and (b) social care providers on increasing opportunities for social prescribing.

The Department and NHS England work closely together to deliver the social prescribing work programme.I met with representatives of the National Academy for Social Prescribing (NASP) on 13 January, a key stakeholder in this field. At the meeting, I confirmed that the Department recognises the value of social prescribing for addressing the wider determinants of health. The NASP shared reports on the evidence for social prescribing and future opportunities for the development of work that they have identified.

How many newly qualified GPs have been employed under the Additional Roles Reimbursement Scheme since August 2024.

Information on the number of recently qualified general practitioners (GPs) for which primary care networks are claiming reimbursement via the Additional Roles Reimbursement Scheme (ARRS) is currently being collated. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published.The Government has delivered an £82 million boost to the ARRS over 2024/25 to enable the recruitment of over 1,000 newly qualified GPs. My Rt Hon. Friend, the Secretary of State for Health and Social Care has confirmed that recently qualified GPs who are employed via the ARRS will continue to be supported through the scheme in 2025/26.