Written questions by Wrigley.

What steps his Department is taking to ensure that ending enhanced payments for NHS nurses covering staff shortages does not increase reliance on agency staff.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What steps his Department is taking to ensure that NHS nurses providing additional cover for staff shortages are adequately compensated.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What assessment his Department has made of the potential impact of ending enhanced payments for NHS nurses covering staff shortages on staffing levels at (a) Royal Devon and Exeter Hospital, (b) North Devon District Hospital and (c) Torbay Hospital.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

What assessment his Department has made of the potential impact of ending enhanced payments for NHS nurses covering staff shortages on the finances of nurses; and what estimate his Department has made of the potential change in agency staffing costs of ending those payments.

These specific assessments have not been made.We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade. This will ensure the National Health Service has the right people, in the right places, with the right skills to deliver the care patients need when they need it.It is the responsibility of local organisations to ensure they have the right numbers of staff with the right skills to deliver services, supported by guidelines by national and professional bodies, including the management of any staff shortages. The Department does not hold information on any locally negotiated arrangements for enhanced payments that individual NHS organisations might offer as incentives to cover staff shortages.The national provisions for payment of unsocial hours premia and overtime are set out in the NHS Terms and Conditions of Service Handbook. These provisions are specific to Agenda for Change staff and include nurses.

If he will convene a stakeholder roundtable to help tackle the shortage of Pancreatic enzyme replacement therapy medication with (a) manufacturers, (b) patient advocacy groups and (c) other relevant stakeholders.

There are no current plans to convene such a roundtable. The Department is in regular discussion with the suppliers of pancreatic enzyme replacement therapy (PERT) on the latest stock availability and the actions that are being taken to mitigate the supply issue that is affecting the whole of the United Kingdom. Through these discussions, we have managed to secure additional volumes for 2025 for the UK. The Department has also reached out to specialist importers who have sourced unlicensed stock to assist in covering the remaining gap in the market.In the longer term, the Department has had interest from non-UK suppliers of PERT wishing to bring their products to the UK and, along with colleagues in the Medicine and Healthcare products Regulatory Agency, we are working with these potential suppliers; if authorised these products could further diversify and strengthen the market. The Department will continue to meet with all suppliers to understand what more can be done to add further resilience to the UK market.In December 2024, the Department issued additional management advice to healthcare professionals. This directs clinicians to consider the unlicensed imports when licensed stock is unavailable and includes actions for integrated care boards to ensure local mitigation plans are put in place and implemented.The Department meets regularly with the affected patient advocacy groups and charities to ensure they are kept informed on the latest supply picture and any communications issued.The Department will continue collaboration with clinicians and representatives from the impacted patient advocacy groups and charities so that they are informed on the supply situation and the mitigation actions being taken.

What assessment he has made of the potential impact of changes to employer National Insurance contributions on the new GP contract.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025. Primary care providers, including general practices, are valued independent contractors who provide almost £20 billion worth of services in the National Health Service. Each year, we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract. We are investing an additional £889 million in general practice (GP) to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. We are pleased that the England general practitioners committee of the British Medical Association is supportive of the contract changes.

What estimate he has made of levels of funding available to GPs following (a) the new GP contract for 2025-26 and (b) changes to employer National Insurance contributions.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025. Primary care providers, including general practices, are valued independent contractors who provide almost £20 billion worth of services in the National Health Service. Each year, we consult with each sector both about what services they provide, and the money providers are entitled to in return under their contract. We are investing an additional £889 million in general practice (GP) to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. We are pleased that the England general practitioners committee of the British Medical Association is supportive of the contract changes.

What steps his Department is taking to ensure that people with an early prostate cancer diagnosis can quickly access (a) treatment and (b) care.

Improving access to treatment and care are key priorities for the Government for all cancer types, including prostate cancer.To achieve this, we have delivered an extra 40,000 operations, scans, and appointments each week, during our first year in Government as the first step to ensuring early diagnosis and faster treatment. Additionally, we will spend £70 million on new radiotherapy machines, to ensure the most advanced treatment is available to patients who need it.Our forthcoming National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as improving access to treatment and care.

If he will make an assessment of the potential merits of protecting the title of nurse in law.

The Government recognises that the protection in law of certain professional titles is important for public safety. Protecting a title provides assurance to the public that someone using that title is competent and safe to practise Although ‘registered nurse’ is a protected title, ‘nurse’ is currently not a protected title. The Government is aware of the concerns which this generates, along with the complications associated with protecting the nurse title, given that it is used in multiple professions; for example, registered nurses, dental nurses, school nurses and veterinary nurses. The Government will continue to work with the professional regulators, including the Nursing and Midwifery Council, as it considers its priorities for professional regulation and will set out its position shortly.

Whether he has had recent discussions with representatives from the pharmacy sector on the supply of Quetiapine modified-release tablets.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

If he will take steps to ensure Quetiapine modified-release tablets are not in shortage for long.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

What assessment he has made of the potential impact of the supply shortage of Quetiapine modified-release tablets on patients.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

If he will take steps to notify patients in need of Quetiapine modified-release tablets when the current shortage is expected to end.

The Department is aware of the supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in the supply through February and early March, with improvements in supply expected to continue through to May, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified release tablets to bring forward these future deliveries. Working with National Health Service specialists, we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time, and are providing up to date information on the availability of the impacted medicines. The Department continues to engage with representatives from the pharmacy sector on the supply of quetiapine modified-release tablets. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

What steps he is taking to help patients with a (a) history and (b) risk of addiction; and if he will take steps to identify that risk before addictive medication is prescribed.

The government is committed to supporting those most vulnerable to experiencing harms from drugs and alcohol, and ensure they are supported to live healthier lives for longer. We are committed to ensuring that anyone with an illicit drug or alcohol dependency can access the help and support they need through evidence-based and high-quality treatment and recovery services. The Department funds local authorities to deliver drug and alcohol treatment services through the Public Health Grant (PHG). In addition to the PHG, the Department allocated local authorities £267 million in 2024/25 to improve the quality and capacity of drug and alcohol treatment and recovery. When prescribing medication, clinicians are expected to work with patients to make decisions about their care and treatment as part of shared decision-making, including discussing risks, benefits, and possible consequences of different options through information-sharing.

If his Department will make an assessment of the potential impact of the proposed increase in secondary Class 1 National Insurance contributions to 15% on (a) care provider employees, (b) the contribution of the care sector to the economy and (c) the future long-term funding settlement for adult social care.

The Government considered the cost pressures facing adult social care as part of the wider consideration of local government spending within the Spending Review process in 2024. To enable local authorities to deliver key services such as adult social care, the Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26 which includes an £880 million increase in the Social Care Grant.The Casey Commission will make longer-term recommendations for the transformation of adult social care, and how to best create a fair and affordable adult social care system.

What assessment he has made of the potential impact of the shortage of quetiapine modified-release tablets on Bipolar patients.

The Department has made no such assessment. We are aware of supply issues affecting several brands and tablet strengths of quetiapine modified release tablets. Following the Department working with suppliers, there have been improvements in supply through February and early March 2025, with improvements in supply expected to continue through to May 2025, and full resolution expected in October 2025. The Department continues to work with the suppliers of quetiapine modified -release tablets to bring forward these future deliveries. Working with National Health Service specialists we have provided comprehensive management advice for this supply issue, advising healthcare professionals on how to manage patients during this time. Any patient who is worried about their condition, or access to these medications, should speak to their clinician in the first instance.

If he will make an assessment of the potential merits of requiring large pharmacies to hold several months of reserve stock of medication.

Pharmacies are independent businesses and are expected to maintain a reasonable stock holding to meet their legal obligations to dispense all prescriptions with reasonable promptness, recognising that it is not feasible for a pharmacy to maintain stock of every medicine.Most pharmacies do not have space to hold several months of stock and such stock holding would come with a financial risk to the pharmacy as stock may expire. There are therefore no plans to require pharmacies to hold reserve stock of medication.

If he will make an assessment of the potential merits of requiring the NHS to offer pocket-sized trauma cards for patients to show during appointments.

There are currently no plans to assess the potential merits of introducing trauma cards in the National Health Service.

If he will make an assessment of the adequacy of assessment times for (a) ADHD, (b) autism and (c) Tourette's syndrome in Devon.

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 access to assessments for attention deficit hyperactivity disorder (ADHD), autism, and Tourette’s syndrome, in line with relevant National Institute for Health and Care Excellence guidance where available.Devon ICB advises it is working with local partners as part of One Devon to implement an integrated neurodiversity assessment pathway to reduce the complexity for families and schools seeking assessment. One Devon is also conducting work focused on autism waiting times recovery.Nationally, NHS England has 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. NHS England has established an ADHD taskforce which will make recommendations about how to address the challenges faced by those affected by ADHD.

Whether he plans to ensure patients can (a) get better access to and (b) find out about (i) research and (ii) clinical trials for rare cancers.

The Department is committed to maximising our potential to lead the world in clinical trials and ensuring that clinical trials are more accessible.The Department funded National Institute for Health and Care Research (NIHR) funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including clinical research on rare cancers. NIHR research expenditure for all cancers was £133 million in 2023/24, reflecting its high priority. These investments are pivotal to informing efforts to improve cancer prevention, treatment, and outcomes, including for rare cancers.The NIHR provides an online service called Be Part of Research, which promotes participation in health and social care research, including research into rare cancers, by allowing users to search for relevant studies and register their interest. This makes it easier for people to find and take part in health and care research that is relevant to them.