Written questions by Evans.

Pursuant to Question 118267 answered on 13 March on General Practitioners: Contracts, who is clinically responsible for the patient while advice and guidance is being sought; and at what point does that responsibility transfer to secondary care.

Currently, a patient is added to an official waiting list when an Advice and Guidance request is converted into a referral. This will remain the case through part of 2026/27. From October 2026, expanded Advice and Guidance will be routed through a new Elective Single Point of Access (SPoA), in line with the Medium Term Planning Framework. From this point, while a patient will still be added onto a waiting list at the point of the referral being accepted, their waiting time will be calculated from the date the Advice and Guidance request or referral was received by the SpoA.While advice is being sought and acted on in primary care, the general practitioner remains responsible for the patient’s overall clinical care and risk. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally take the patient on. Specialist also have clinical responsibility from the point an Advice and Guidance request is converted into a referral or if the specialist initiates investigations or treatment directly.

With reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, whether he has made an assessment of the impact of removing the cap on online requests that can be submitted during core hours on (a) patient safety and (b) GP workload.

The Department has not made a specific assessment of the impact of removing the caps on online requests on patient safety and general practice (GP) workload. Data on online consultation submissions is collected, monitored, and published.This is because there is no change to clinical responsibility, triage processes, or same‑day requirements for clinically urgent care as a result of this clarification. Practices retain flexibility over how requests are prioritised and responded to, including the use of triage models and appropriate response times for non‑urgent requests. Evidence from practices shows that spreading demand more evenly across the day can support smoother workflows and reduce pressure on telephone access, rather than increasing overall workload.The clarification on online access is being implemented alongside wider GP Contract changes for 2026/27, including £485 million in additional core funding and reforms intended to support practice capacity.

What his planned timetable is for publishing operational guidance for the use of Advice and Guidance in the context of the GP contract 2026/27.

As part of the usual annual cycle, NHS England will refresh the operational delivery framework to ensure it remains aligned with the updated contractual requirements. The GP Contract changes for 2026/27 are underpinned by regulations, which will be laid before Parliament in the usual way, alongside an explanatory memorandum. Framework updates will happen in line with, or prior to, regulations coming into force. NHS England will continue to ensure that operational delivery frameworks remain clear, robust, and supportive as the use of Advice and Guidance expands.

If he will ask NHS England to set out the definition of ‘clinically urgent’ for patients who need to be dealt with on the same day in the context of the the GP contract 2026/27.

As part of the 2026/27 GP Contract, we are amending the core contract to explicitly require that requests identified as clinically urgent must be dealt with on the same day. It is for practices to use their clinical judgement to determine which requests are clinically urgent.

With reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, whether the money to fund the practice-level GP reimbursement scheme will be new funding.

Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level general practice reimbursement scheme using £292 million of repurposed funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional general practitioners (GPs) or to fund additional sessions with existing GPs to improve access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment. This is good value for the taxpayer and guarantees the money is spent on GPs.

Whether Advice and Guidance will be mandatory for GPs to use in the context of the GP contract 2026/27.

As part of the 2026/27 GP Contract, we are embedding the current Advice and Guidance (A&G) enhanced service funding within core practice funding. Practices will be required to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.A&G has shown clear value in supporting timely specialist input, reducing unnecessary referrals, and ensuring patients receive timely care in the most appropriate setting.Between April 2025 and December 2025, A&G has avoided 1.3 million patients being added to waiting lists.

With reference to the GP contract 2026/27, whether every non-cancer referral will need to go through Advice and Guidance.

As part of the 2026/27 GP Contract, we are embedding the current Advice and Guidance (A&G) enhanced service funding within core practice funding. Practices will be required to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.A&G has shown clear value in supporting timely specialist input, reducing unnecessary referrals, and ensuring patients receive timely care in the most appropriate setting.Between April 2025 and December 2025, A&G has avoided 1.3 million patients being added to waiting lists.

What his planned timetable is for informing children’s hospices of their individual allocations from recent funding announcements.

Children and young people’s hospices have been informed of their allocations for 2026/27 by NHS England. Communications regarding future allocations, for 2027/28 and 2028/29, will be sent once the 2026/27 process is complete.

Whether all hospice services are required to be commissioned.

The majority of hospices are charitable, independent organisations and, therefore, the Government does not collect or keep data on hospice bed capacity nationally. There are no current plans to make a formal assessment of the adequacy of hospice bed capacity.Integrated care boards (ICBs) are responsible for commissioning core and specialist palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

If he will make an assessment of the adequacy of hospice bed capacity and how this is tracked nationally.

The majority of hospices are charitable, independent organisations and, therefore, the Government does not collect or keep data on hospice bed capacity nationally. There are no current plans to make a formal assessment of the adequacy of hospice bed capacity.Integrated care boards (ICBs) are responsible for commissioning core and specialist palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

What assessment he has made of the adequacy of the current National Institute for Health and Care Excellence clinical guidelines on generalised anxiety disorder and panic disorder in adults.

National Institute for Health and Care Excellence (NICE) guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with a wide range of stakeholders. They represent best practice, and healthcare professionals are expected to take them fully into account in the care and treatment of their patients. NICE keeps its guidance under active surveillance and decisions on whether published guidelines should be updated in light of new evidence are taken by the NICE prioritisation board, chaired by the NICE Chief Medical Officer, in line with its published prioritisation framework. There are currently no plans to update the guideline on generalised anxiety and panic disorder.

What assessment he has made of the potential impact of mandating Advice and Guidance requests on the legal and accountability frameworks for clinicians.

Changes introduced as part of the 2025/26 GP Contract consultation included the introduction of the Enhanced Service for Advice and Guidance (A&G). This built upon existing use of A&G pathways by general practice over previous years, which helped to ensure patients received care at the right place and the right time. The Department and NHS England are embedding A&G into the core GP Contract for 2026/27. This removes the need for annual sign‑up and treats A&G as routine clinical practice with predictable, recurrent funding.The use of A&G does not alter existing legal or professional accountability frameworks, and supportive guidance is available to help signpost these responsibilities. Clinical decisions remain with appropriately qualified professionals under established regulatory and local governance arrangements, and NHS England continues to ensure these frameworks remain clear and robust as the use of A&G expands, including through job planning guidance that supports clinicians to manage this activity safely and appropriately.

In relation to the GP contract 2026/27, what framework he has put in place to help ensure that hospitals respond to Advice and Guidance requests in a timely manner.

Advice and Guidance (A&G) is a clinical collaboration tool that supports timely specialist input and helps patients receive care in the right setting, enabling best use of clinical time.The GP Contract 2026/27 sets out that practices will be required to use A&G prior to, or in place of, a planned care referral where clinically appropriate. It also sets out the expectation for practices to follow locally agreed referral pathways, including single point of access (SPoA) models once introduced. Similarly, our Medium-term Planning Framework, published in October 2026, introduced plans to support increased A&G by moving to an elective SPoA model. All appropriate referrals and requests, other than those for urgent suspected cancer, will be directed through a single ‘front door’ to support triage to the most appropriate next step or outcome for the patient. This will help reduce unnecessary appointments, making the best use of clinical time. The Medium-Term Planning Framework set the aim for all referrals to go via a SPoA for at least 10 specialties determined at provider level by October 2026, which provides flexibility for local teams to deliver where there is the most potential for the model to be effective, including ensuring timely responses.Integrated care boards are expected to support the introduction of expanded A&G and SPoA through their strategic commissioning for 2026/27. National Health Service trusts will continue to be funded to deliver A&G through a fixed payment negotiated locally to ensure predictable and sufficient funding to cover increased A&G use. NHS England will continue to work with systems to monitor performance, share good practice, and support timely responses, including through job planning guidance that supports clinicians to manage A&G safely and appropriately.

In relation to the GP contract 2026/27, how his Department plans to support hospitals in dealing with the increased caseloads generated by mandating Advice and Guidance.

Advice and Guidance (A&G) is a clinical collaboration tool that supports timely specialist input and helps patients receive care in the right setting, enabling best use of clinical time.The GP Contract 2026/27 sets out that practices will be required to use A&G prior to, or in place of, a planned care referral where clinically appropriate. It also sets out the expectation for practices to follow locally agreed referral pathways, including single point of access (SPoA) models once introduced. Similarly, our Medium-term Planning Framework, published in October 2026, introduced plans to support increased A&G by moving to an elective SPoA model. All appropriate referrals and requests, other than those for urgent suspected cancer, will be directed through a single ‘front door’ to support triage to the most appropriate next step or outcome for the patient. This will help reduce unnecessary appointments, making the best use of clinical time. The Medium-Term Planning Framework set the aim for all referrals to go via a SPoA for at least 10 specialties determined at provider level by October 2026, which provides flexibility for local teams to deliver where there is the most potential for the model to be effective, including ensuring timely responses.Integrated care boards are expected to support the introduction of expanded A&G and SPoA through their strategic commissioning for 2026/27. National Health Service trusts will continue to be funded to deliver A&G through a fixed payment negotiated locally to ensure predictable and sufficient funding to cover increased A&G use. NHS England will continue to work with systems to monitor performance, share good practice, and support timely responses, including through job planning guidance that supports clinicians to manage A&G safely and appropriately.

What assessment he has made of the adequacy of the complaints signposting available to those who self-fund their social care.

By law, all health and social care services must have a procedure for dealing efficiently with complaints, and anyone who has seen or experienced poor-quality care has the right to complain to the organisation that provided or paid for the care.If an individual has raised a complaint and is not satisfied with the way a provider has dealt with their complaint, they may escalate it to the Local Government and Social Care Ombudsman (LGSCO) who can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care.The Government has continued discussions with the LGSCO and the Care Quality Commission about how the regulator can most effectively support the signposting of self-funders to the LGSCO by private providers.

What steps he is taking to help ensure those who self-fund their social care have access to appropriate complaints procedures available to them.

By law, all health and social care services must have a procedure for dealing efficiently with complaints, and anyone who has seen or experienced poor-quality care has the right to complain to the organisation that provided or paid for the care.If an individual has raised a complaint and is not satisfied with the way a provider has dealt with their complaint, they may escalate it to the Local Government and Social Care Ombudsman (LGSCO) who can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care.The Government has continued discussions with the LGSCO and the Care Quality Commission about how the regulator can most effectively support the signposting of self-funders to the LGSCO by private providers.

Pursuant to the Answers of 5 February 2026 to Questions 108785, 108786 and 108787 on Physiotherapy: Employment, what steps he is taking to understand workforce planning and service need for physiotherapists in the NHS.

NHS England’s regional teams are in constant dialogue with integrated care boards, National Health Service trusts, other bodies providing NHS services, and education and training providers to assess workforce challenges and support appropriate training across a range of services, including those involving physiotherapists.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. We have engaged with partners throughout the development of the 10 Year Workforce Plan, including through the call for evidence, which received over 900 responses, and a national partner event which included representatives from over 90 organisations shaping early thinking across key themes.

What his planned timetable is for responding to the Kingdon Review.

The timetable for responding to the Kingdon Review has not yet been determined. We are continuing to examine the findings of the review.

Pursuant to the Answers of 5 February 2026 to Questions 108785, 108786 and 108787 on Physiotherapy: Employment, if he will initiate conversations with NHS England about the extent of (a) current job vacancies, (b) job competition and (c) longevity of NHS Employment for physiotherapists in the NHS.

The Department and NHS England continue work closely together on National Health Service workforce planning.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 NHS has the right people in the right places, with the right skills to care for patients, when they need it. Work is ongoing between the Department and NHS England on the development of the 10 Year Workforce Plan, which will have implications on workforce planning for both physiotherapists, and other allied health professions.Decisions about recruitment are a matter for individual NHS employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.

Pursuant to the Answers of 5 February 2026 to Questions 108785, 108786 and 108787 on Physiotherapy: Employment, if he will undertake a review of data gathering about (a) job vacancies, (b) job competition and (c) longevity of NHS Employment for physiotherapists in the NHS.

The Department has no plans for a review of the data gathered in relation to physiotherapy job vacancies, job competition, and the longevity of National Health Service employment in the NHS.