Written questions by Wrigley.

With reference to NHS England's guidance entitled 2025/26 priorities and operational planning guidance, published on 30 January 2025, if he will make an assessment of the potential impact of the removal of the dementia diagnosis target rate on (a) support and (b) treatment for non-diagnosis dementia patients.

We remain committed to increasing dementia diagnosis rates and agree that early diagnosis is vital to ensure people with dementia can access the treatment and support they need.We have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the National Health Service around by doing things differently. These are the first steps on our journey for long-term reform of the NHS.NHS Planning Guidance is not an exhaustive list of everything the NHS does, and the absence of a target does not mean it is not an area of focus. The Darzi Investigation found that there are too many targets set for the NHS, which made it hard for local systems to prioritise their actions or to be held properly accountable.Our aim is to give more power to local systems and let them decide how they use local funding to best meet the needs of their local population. This approach signals our ambition for reform, recognises the role of the NHS in driving economic growth, and enshrines our commitment to financial rigour in the system.Through our extensive public engagement as part of the 10-Year Health Plan, we will continue to listen to patients’ priorities and keep focused on what matters most to the public.Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.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.

With reference to NHS England's guidance entitled 2025/26 priorities and operational planning guidance, published on 30 January 2025, if he will make an assessment of the potential impact of the removal of the dementia diagnosis target rate on the NHS.

We remain committed to increasing dementia diagnosis rates and agree that early diagnosis is vital to ensure people with dementia can access the treatment and support they need.We have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the National Health Service around by doing things differently. These are the first steps on our journey for long-term reform of the NHS.NHS Planning Guidance is not an exhaustive list of everything the NHS does, and the absence of a target does not mean it is not an area of focus. The Darzi Investigation found that there are too many targets set for the NHS, which made it hard for local systems to prioritise their actions or to be held properly accountable.Our aim is to give more power to local systems and let them decide how they use local funding to best meet the needs of their local population. This approach signals our ambition for reform, recognises the role of the NHS in driving economic growth, and enshrines our commitment to financial rigour in the system.Through our extensive public engagement as part of the 10-Year Health Plan, we will continue to listen to patients’ priorities and keep focused on what matters most to the public.Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.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.

With reference to NHS England's guidance entitled 2025/26 priorities and operational planning guidance, published on 30 January 2025, if he will make an assessment of the potential impact of the removal of the dementia diagnosis target rate on local health service accountability.

We remain committed to increasing dementia diagnosis rates and agree that early diagnosis is vital to ensure people with dementia can access the treatment and support they need.We have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the National Health Service around by doing things differently. These are the first steps on our journey for long-term reform of the NHS.NHS Planning Guidance is not an exhaustive list of everything the NHS does, and the absence of a target does not mean it is not an area of focus. The Darzi Investigation found that there are too many targets set for the NHS, which made it hard for local systems to prioritise their actions or to be held properly accountable.Our aim is to give more power to local systems and let them decide how they use local funding to best meet the needs of their local population. This approach signals our ambition for reform, recognises the role of the NHS in driving economic growth, and enshrines our commitment to financial rigour in the system.Through our extensive public engagement as part of the 10-Year Health Plan, we will continue to listen to patients’ priorities and keep focused on what matters most to the public.Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.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.

With reference to NHS England's guidance entitled 2025/26 priorities and operational planning guidance, published on 30 January 2025, if he will make an assessment of the potential impact of the removal of the dementia diagnosis target rate on the number of patients at risk of going into urgent care.

We remain committed to increasing dementia diagnosis rates and agree that early diagnosis is vital to ensure people with dementia can access the treatment and support they need.We have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the National Health Service around by doing things differently. These are the first steps on our journey for long-term reform of the NHS.NHS Planning Guidance is not an exhaustive list of everything the NHS does, and the absence of a target does not mean it is not an area of focus. The Darzi Investigation found that there are too many targets set for the NHS, which made it hard for local systems to prioritise their actions or to be held properly accountable.Our aim is to give more power to local systems and let them decide how they use local funding to best meet the needs of their local population. This approach signals our ambition for reform, recognises the role of the NHS in driving economic growth, and enshrines our commitment to financial rigour in the system.Through our extensive public engagement as part of the 10-Year Health Plan, we will continue to listen to patients’ priorities and keep focused on what matters most to the public.Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible.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.

If he will take steps to improve access to the NHS for transgender adults.

The Government wants all patients, including transgender adults, to feel safe and confident in accessing National Health Service health services. This is part of our mission to ensure that the NHS is there for everyone when they need it, providing equal access to health care which promotes choice and inclusivity. Transgender adults may seek access to NHS gender services specifically and these should be available when needed. NHS England has increased the number of adult Gender Dysphoria Clinics in England from seven to 12. The rollout of these new clinics is helping to tackle long waiting times, which had increased due to a shortage of specialist clinical staff to meet the rapidly rising demand. NHS England is currently undertaking a review of adult gender services, chaired by Dr David Levy. The review will examine the model of care and operating procedures of each service, and will carefully consider experiences, feedback, and outcomes from clinicians and patients, with the aim of producing an updated service specification.

What recent discussions he has had with the NHS on the dementia diagnosis target rate.

We remain committed to increasing dementia diagnosis rates and agree that early diagnosis is vital to ensure people with dementia can access the treatment and support they need. NHS Planning Guidance is not an exhaustive list of everything the National Health Service does, and the absence of a target does not mean it is not an area of focus. Lord Darzi’s independent review showed that a timely diagnosis is vital to ensuring that a person with dementia can access the advice, information, care, and support that can help them to live well and remain independent for as long as possible. The dementia diagnosis target has not been met for half a decade.We have taken a new approach to NHS Planning Guidance this year, reducing the number of national directives from 32 to 18. We will only turn the NHS around by doing things differently. These are the first steps on our journey for long-term reform of the NHS.The Darzi investigation found that there are too many targets set for the NHS, which made it hard for local systems to prioritise their actions or to be held properly accountable. Our aim is to give more power to local systems and let them decide how they use local funding to best meet the needs of their local population. This approach signals our ambition for reform and putting patients at the centre of care.Through our extensive public engagement as part of the 10-Year Health Plan, we will continue to listen to patients’ priorities and keep focused on what matters most to the public. 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.

What guidance his Department has issued to NHS Trusts on tackling administrative barriers to access to Givinostat treatment.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, 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 does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What steps his Department is taking to ensure that NHS Trusts are (a) aware of and (b) encouraged to participate in the Givinostat Early Access Programme.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, 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 does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What steps his Department is taking with NHS England to ensure that eligible patients have access to Givinostat employee assistance programmes.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, 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 does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

What steps he is taking to ensure access to Givinostat for families of children with Duchenne muscular dystrophy.

ITF Pharma UK, the United Kingdom marketing authorisation holder for givinostat, is providing access to givinostat through a type of compassionate use scheme called an Early Access Programme (EAP). Under the EAP, givinostat is free to both patients taking part in it and to the National Health Service, 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 does not have any initiatives to encourage participation in compassionate use schemes, which are the responsibility of individual pharmaceutical companies. Participation in the EAP for givinostat, which must be through one of the 23 NorthStar Centres in the UK, is decided at an individual NHS trust level, although there is general advice that trusts should engage with the relevant commissioner if they choose to participate, so that any impacts on the wider service can be taken into account. A NorthStar Centre will not be able to provide givinostat if its local trust has not approved participation.NHS England has published guidance for integrated care systems (ICS) on free of charge medicines schemes such as EAPs, including providing advice on potential financial, administrative, and clinical risks. The guidance aims to support the NHS to drive value from the medicines and ensure consistent and equitable access to medicines across England. ICSs should follow the recommendations to determine whether to implement any free of charge scheme, including assessing suitability and any risks in the short, medium, and long term. The guidance is available at the following link:https://www.england.nhs.uk/long-read/free-of-charge-foc-medicines-schemes-national-policy-recommendations-for-local-systems/

If he will provide additional funding for local dental laboratories.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has uplifted NHS primary care dentistry contract values by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift.The Government implemented the overall uplift to contract values on 29 January. Uplifted payments will be made in March, backdated to 1 April 2024.

Whether his Department is taking steps to support the manufacture of dental appliances in Devon.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The NHS contracts independent dental providers to deliver NHS dental treatment. Providers are able to make choices about how they operate within the terms of the contract, including choice over the dental laboratory suppliers they use, providing they remain compliant with the appropriate regulations.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that NHS primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift. The Government is acting to implement the overall uplift to contract values as soon as possible.

What steps his Department is taking to support NHS dental laboratories in Devon.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The NHS contracts independent dental providers to deliver NHS dental treatment. Providers are able to make choices about how they operate within the terms of the contract, including choice over the dental laboratory suppliers they use, providing they remain compliant with the appropriate regulations.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that NHS primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift. The Government is acting to implement the overall uplift to contract values as soon as possible.

What steps his Department is taking to support dental laboratories affected by rising energy costs in Devon.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The NHS contracts independent dental providers to deliver NHS dental treatment. Providers are able to make choices about how they operate within the terms of the contract, including choice over the dental laboratory suppliers they use, providing they remain compliant with the appropriate regulations.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that NHS primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift. The Government is acting to implement the overall uplift to contract values as soon as possible.

What plans he has to support dental laboratories; and whether he plans to use a review of NHS Dentistry contracts to protect them.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The NHS contracts independent dental providers to deliver NHS dental treatment. Providers are able to make choices about how they operate within the terms of the contract, including choice over the dental laboratory suppliers they use, providing they remain compliant with the appropriate regulations.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that NHS primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift. The Government is acting to implement the overall uplift to contract values as soon as possible.

Whether his Department is taking steps to support dental laboratories to achieve next day manufacture of dental appliances in Devon.

We recognise the importance of dental laboratories and the role they play in support of National Health Service dental services.The NHS contracts independent dental providers to deliver NHS dental treatment. Providers are able to make choices about how they operate within the terms of the contract, including choice over the dental laboratory suppliers they use, providing they remain compliant with the appropriate regulations.The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that NHS primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift. The Government is acting to implement the overall uplift to contract values as soon as possible.

What steps his Department to tackle shortages of NHS dentists in Devon.

We are aware of the challenges people face in accessing a dentist, particularly in more rural and coastal areas. 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 areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.Integrated care boards have started to advertise posts through the Golden Hello scheme. This recruitment incentive will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years.

What steps his Department is taking to help support people with long covid in Devon.

NHS Devon continues to provide long COVID services for patients in Devon. The services are provided by the Royal Devon University Healthcare NHS Foundation Trust, Livewell Southwest and Torbay, and the South Devon NHS Foundation Trust.

What steps his Department is taking to help support people with ME in Devon.

Integrated care boards are responsible for commissioning specialist myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), services that meet the needs of their population, including in Devon, subject to local prioritisation and funding.NHS England colleagues in the south west of England have engaged with the Royal Devon University Healthcare NHS Foundation Trust, which is in the process of developing formal pathways for acute admission and emergency admission for patients with ME/CFS.

Whether he has made an assessment of the potential impact of changes in the budget on dental laboratories; and if he will take steps to ensure that the dental contract reflects actual costs for dental laboratories.

The independent pay review body for doctors and dentists recommended a 6% pay uplift for 2024/25. The Government accepted the recommendation and has proposed that National Health Service primary care dentistry contract values be uplifted by 4.64%, net of pay and expenses elements. Laboratory costs are part of the expenses element of this uplift.The Government is acting to implement the overall uplift to contract values as soon as possible. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.