Written questions by Wrigley.

What assessment his Department has made of the potential impact of the planned (a) budgetary reductions and (b) structural reorganisation in NHS Devon on (i) waiting times for surgery and (ii) emergency care.

No formal assessment has been made on the potential impact of the planned budgetary reductions and structural reorganisation in NHS Devon on waiting times for surgery and emergency care.Following the Prime Minister’s announcement of the abolition of NHS England, we are clear on the need for a smaller centre, as well as scaling back integrated care board (ICB) running costs and NHS provider corporate cost reductions in order to reduce waste and bureaucracy.We have recently announced the Spending Review settlement which provides an additional £29 billion of annual day-to-day spending in real terms by 2028/29, compared to 2023/24. Ahead of asking the National Health Service to commence a multi-year planning round, we are now carefully reviewing how the settlement is prioritised, including making provision for redundancy costs.The 10-Year Health Plan sets out that ICBs must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities.Each ICB is therefore responsible for considering local needs to meet the expectations set out in planning guidance.As of August 2025, 62.1% of pathways in NHS Devon ICB were completed within 18 weeks. This has improved by 3.4 percentage points since August 2024.

What steps his Department is taking to ensure that (a) integrated care boards and (b) trusts (i) collect and (ii) publish data on the provision of respiratory diagnostics.

Neighbourhood level respiratory diagnostic hubs support our vision of delivering more diagnostics and care outside of hospitals and in communities. Respiratory diagnostic hubs have been piloted and developed in many parts of England, and this learning will be informing the development of more neighbourhood health services.Community diagnostic centres (CDCs) are also supporting this vision, as 170 CDCs are now operational across England. All standard model CDCs are required to offer a range of diagnostic tests that support the diagnosis of respiratory conditions, including spirometry and lung function tests.CDCs offer local populations a wide range of diagnostic tests, including respiratory diagnostic services, closer to home and with greater choice on where and how they are undertaken, reducing the need for hospital visits and speeding up diagnosis, whilst also reducing pressure on hospitals.We are continuing to invest in expanding diagnostic capacity in the National Health Service, including through increasing CDC capacity. As set out in the Elective reform Plan, we plan to build up to five more CDCs in 2025/26, alongside increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week.Integrated care boards (ICBs) play a vital role in commissioning and shaping diagnostic services to meet the needs of their local populations. Addressing the earlier diagnosis and treatment of their populations with respiratory conditions is a significant priority for ICBs.ICBs are responsible for commissioning Local Enhanced Services, including respiratory diagnostics, which are not agreed nationally and can vary in scope and funding to fit local needs.Activity and waiting times for the main respiratory tests are not included in the National Diagnostic Activity and Waiting Times Collection. However, NHS England’s National Diagnostic Programme undertakes an annual snap-shop data collection in respiratory diagnostics to understand levels of activity and waiting times for a range of respiratory tests within trusts across England.NHS England’s Respiratory Programme, in collaboration with national stakeholders, has also developed a standardised spirometry data capture template. This tool is designed to support ICBs in consistently recording and reporting spirometry activity, enabling improved oversight, service planning, and equitable access to respiratory diagnostics.

What steps his Department is taking to monitor the potential impact of the restructuring of integrated care boards in Devon on the health of (a) vulnerable groups disproportionately affected by health inequalities and (b) people living in (i) Teignmouth, (ii) Dawlish and (iii) coastal towns.

To deliver the required reduction in running costs in 2025/26, a number of integrated care boards (ICBs) will cluster together to share leadership and functions so resources can be directed to frontline services. ICBs have a crucial role as strategic commissioners of local healthcare services and remain responsible for ensuring the provision of services to meet the needs of the populations they serve, including those from small and coastal towns.While clustering ICBs will work together through shared leadership and combined teams, they will remain separate legal entities. NHS England shared a ‘Model ICB blueprint’ with ICBs in May 2025 to help them form their plans. This makes clear that ICBs are expected to maintain clear, accountable leadership with effective governance during the transition and beyond.

What steps his Department is taking to ensure that (a) integrated care boards and (b) trusts provide a (i) locally enhanced service and (ii) similar arrangement to support the establishment of respiratory diagnostic hubs.

Neighbourhood level respiratory diagnostic hubs support our vision of delivering more diagnostics and care outside of hospitals and in communities. Respiratory diagnostic hubs have been piloted and developed in many parts of England, and this learning will be informing the development of more neighbourhood health services.Community diagnostic centres (CDCs) are also supporting this vision, as 170 CDCs are now operational across England. All standard model CDCs are required to offer a range of diagnostic tests that support the diagnosis of respiratory conditions, including spirometry and lung function tests.CDCs offer local populations a wide range of diagnostic tests, including respiratory diagnostic services, closer to home and with greater choice on where and how they are undertaken, reducing the need for hospital visits and speeding up diagnosis, whilst also reducing pressure on hospitals.We are continuing to invest in expanding diagnostic capacity in the National Health Service, including through increasing CDC capacity. As set out in the Elective reform Plan, we plan to build up to five more CDCs in 2025/26, alongside increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week.Integrated care boards (ICBs) play a vital role in commissioning and shaping diagnostic services to meet the needs of their local populations. Addressing the earlier diagnosis and treatment of their populations with respiratory conditions is a significant priority for ICBs.ICBs are responsible for commissioning Local Enhanced Services, including respiratory diagnostics, which are not agreed nationally and can vary in scope and funding to fit local needs.Activity and waiting times for the main respiratory tests are not included in the National Diagnostic Activity and Waiting Times Collection. However, NHS England’s National Diagnostic Programme undertakes an annual snap-shop data collection in respiratory diagnostics to understand levels of activity and waiting times for a range of respiratory tests within trusts across England.NHS England’s Respiratory Programme, in collaboration with national stakeholders, has also developed a standardised spirometry data capture template. This tool is designed to support ICBs in consistently recording and reporting spirometry activity, enabling improved oversight, service planning, and equitable access to respiratory diagnostics.

What plans his Department has to reduce the impact of chronic respiratory conditions on the NHS in winter 2025-26.

NHS England, working with the Department, the UK Health Security Agency and other partners, is taking action to reduce the impact of respiratory conditions on the National Health Service this winter. This includes robust, consistent infection prevention and control measures, and the campaign to encourage eligible people to get their winter vaccinations. Further details of the actions being taken to reduce demand on acute services during winter are available at the following link: https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/

If he will take steps to ensure that (a) couples and (b) families are able to use the same email when signing up for the NHS app.

Instead of sharing an email, the NHS App supports proxy access through linked profiles, enabling parents or carers to manage health services for children or dependents through properly configured access. The registered email address and multi-factor authentication is used for security-sensitive activities, such as resetting an NHS login password or recovering an account, so should be kept private, ensuring an individual’s data is protected and secured in compliance with the requirements of Article 5.1(f), the ‘integrity and confidentiality’ principle, of the UK General Data Protection Regulation.Using and sharing the same email address for multiple users may increase the risk of exposing sensitive health information inadvertently to others, limit controls to protect individuals against coercive behaviour, and increase the risk of cyberattacks including brute force attacks and fraudulent access.

If he will make an assessment of the potential impact of recent trends in running costs for NHS Devon on (a) the provision of public health services and (b) health outcomes in the region.

Public health responsibilities sit primarily with local authorities and national public health programmes, such as screening, are commissioned by NHS England rather than the integrated care boards (ICBs). Therefore, the running costs within the NHS Devon ICB do not directly affect the provision of public health services. There are ongoing discussions nationally about the potential future delegation of some public health and screening functions to ICBs, but no decisions have yet been made. NHS Devon’s new Health and Care Strategy set out a system-wide approach to improving health outcomes and reducing inequalities through prevention, early intervention, and community-based care. This will support better long-term population health across Devon, regardless of ICB running cost trends. The ICB’s meeting papers and minutes discussing the strategy is available at the following link: https://swpboard.nhs.uk/board-meetings/board-meeting-papers-and-minutes/

If he will take steps to help protect (a) safeguarding, (b) continuing healthcare and (c) support for people with special educational needs and disabilities during the transition to the new integrated care board cluster in Devon, Cornwall and the Isles of Scilly.

To support integrated care boards (ICBs) as they reduce their running costs, which includes moving to new clusters in some areas, NHS England has been working with stakeholders on further detail. NHS England has shared best practice documents in relation to NHS Continuing Healthcare, support for people with special educational needs and disabilities, and safeguarding. These documents are clear on ICBs’ statutory requirements and set out that the focus in the near term will be on spreading best practice in the delivery of these functions, ensuring the function is delivered as efficiently and effectively as possible by all ICBs.

If his Department will publish an impact assessment for the NHS Devon Integrated Care Board’s proposed 2025–26 financial plan that includes information on the services that may be (a) restructured and (b) reduced to meet targets.

NHS Devon’s 2025/26 financial plan is being developed in line with national planning guidance and forms part of the wider five-year Medium Term Financial Plan. The plan is focused on achieving financial sustainability while improving health outcomes and reducing inequalities. All proposals for service change will be supported by equality and quality impact assessments and appropriate engagement with local stakeholders. NHS Devon is committed to maintaining safe and sustainable services by shifting care closer to home and reducing reliance on acute settings. Efficiency improvements across the Devon system total approximately £255 million in 2025/26. These measures are designed to improve productivity and value for money, not to reduce essential services. A summary of the Health and Care Strategy and financial plan will be shared with Members of Parliament and stakeholders, and a briefing for Members of Parliament for Devon will be arranged following publication.

Whether NHS England has included requirements for sovereign AI capability in contracts awarded under the Federated Data Platform.

A mandatory requirement across all awarded contracts under the NHS Federated Data Platform is that any processing of data, whether involving artificial intelligence (AI) capabilities or not, must adhere to strict UK data governance regulations. This explicitly includes a data residency requirement, stipulating that all data must be stored and processed within the United Kingdom. This ensures all data remains subject to UK law and regulatory oversight.The use of any foundational models is restricted exclusively to models that are hosted within the UK and all with UK endpoints. This policy ensures that the core AI processing, in addition to the data itself, remains within the nation's jurisdiction, thereby ensuring a sovereign AI capability by design.

Whether his Department has issued guidance to integrated care boards on protecting frontline public health services.

NHS England has issued guidance to integrated care boards (ICBs) on their public health functions, for instance the guidance Delivering a quality public health function in integrated care boards, which is available at the following link:Delivering-a-quality-public-health-function-in-integrated-care-boards-October-2022.pdf.More recently, NHS England issued a Model Integrated Care Board Blueprint in May 2025, suggesting the functions needed for ICBs to fulfil their roles as strategic commissioners. This included ICBs providing system leadership for population health.

With reference to page 91 of his Department's policy paper entitled Fit for the future: 10 year health plan for England, published 1 July 2025, what criteria was used to determine which conditions should receive a modern service framework; and whether respiratory health meets these criteria.

Everyone in the National Health Service is responsible for delivering high-quality care. As announced in the 10-Year Health Plan, as well as an overall quality strategy, the National Quality Board will oversee the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in the quality of care and productivity.Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia. The Government will consider other long-term conditions with significant health and economic impacts for future waves of modern service frameworks.

What assessment his Department has made of the merits of producing a modern service framework for respiratory care.

Everyone in the National Health Service is responsible for delivering high-quality care. As announced in the 10-Year Health Plan, as well as an overall quality strategy, the National Quality Board will oversee the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in the quality of care and productivity.Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia. The Government will consider other long-term conditions with significant health and economic impacts for future waves of modern service frameworks.

If he will make an assessment of the potential impact of planned changes to funding for NHS services in Devon on (a) health inequalities and (b) funding for public health programmes.

NHS Devon’s financial planning aligns with the NHS England planning round. The integrated care board is developing detailed commissioning intentions to allocate resources in line with its five-year Health and Care Strategy. This strategy prioritises tackling health inequalities through targeted prevention, integrated neighbourhood care, and population health management. Funding for local authority public health programmes is not affected by changes to NHS Devon’s internal budget allocations.

If he will make an assessment of the adequacy of the availability of radiotherapy services to patients in Devon.

We will improve National Health Service waiting time performance, so patients are diagnosed faster and have quicker access to the treatments they require, including radiotherapy. However, we do recognise that there is much more to be done to ensure that this is the reality for all patients across the country, including Devon.Radiotherapy is vital in cancer care, and it remains a key priority for the Government to reduce radiotherapy waiting times and provide the highest quality of treatment available. This is why the Government has invested £70 million of central funding on 28 new LINAC radiotherapy machines across the country to replace older, less efficient radiotherapy machines. The new machines were allocated across England and funding was allocated to trusts using criteria that NHS England developed. These criteria focused on the age of the machine being replaced, the proportion of older machines in use within the trust, and the trust’s performance on radiotherapy. The University Hospitals Plymouth NHS Trust, the local provider for cancer services in Devon, has been awarded funding for a replacement machine.The forthcoming National Cancer Plan will include further details on how we will ensure all patients have access to the latest treatments and technology, ultimately driving up this country’s cancer survival rates.

If she will take steps to improve radiotherapy services in Devon.

We will improve National Health Service waiting time performance, so patients are diagnosed faster and have quicker access to the treatments they require, including radiotherapy. However, we do recognise that there is much more to be done to ensure that this is the reality for all patients across the country, including Devon.Radiotherapy is vital in cancer care, and it remains a key priority for the Government to reduce radiotherapy waiting times and provide the highest quality of treatment available. This is why the Government has invested £70 million of central funding on 28 new LINAC radiotherapy machines across the country to replace older, less efficient radiotherapy machines. The new machines were allocated across England and funding was allocated to trusts using criteria that NHS England developed. These criteria focused on the age of the machine being replaced, the proportion of older machines in use within the trust, and the trust’s performance on radiotherapy. The University Hospitals Plymouth NHS Trust, the local provider for cancer services in Devon, has been awarded funding for a replacement machine.The forthcoming National Cancer Plan will include further details on how we will ensure all patients have access to the latest treatments and technology, ultimately driving up this country’s cancer survival rates.

What discussions he has had with ICBs on providing GP practices with (a) clearer and (b) more transparent criteria on the approval process for (i) surgery expansion and (ii) new builds.

The Government is committed to delivering a National Health Service that is fit for the future, and we recognise delivering high quality NHS healthcare requires the right infrastructure in the right places.Surgery expansion and new builds are considered by local integrated care boards (ICB’s) under the auspices of The National Health Service (General Medical Services - Premises Costs) Directions 2024, with further information available at the following link:https://assets.publishing.service.gov.uk/media/663cd8d2bd01f5ed32793867/nhs_general-medical-services-premises-costs_directions-2024.pdfThis guidance sets out the clear and transparent criteria for the application process and provide the ability for ICBs to invest capital into new primary care premises, which was not supported under earlier versions.To further support general practice contractors and ICBs, NHS England has published two documents, the Guide to the changes to primary care premises policy document, to provide an overview of the changes to the directions, and the Primary care capital grants policy document, to provide guidance on the investment of capital. Both documents are available, respectively, at the following two links:https://www.england.nhs.uk/long-read/guide-to-the-changes-to-primary-care-premises-policy/https://www.england.nhs.uk/long-read/primary-care-capital-grants-policy/For this financial year, 2025/26, the Government is providing £102 million of capital investment into upgrading the general practice estate across England in the form of the Utilisation and Modernisation Fund. Using targeted investment to create additional clinical capacity enabling practices to see more patients, boost productivity, and improve patient care. Most of the schemes will involve the repurposing of existing accommodation with a small number of modest surgery extensions.

What steps he is taking to ensure that local decision-making by ICBs is in line with national strategic priorities for primary care infrastructure growth.

The Government is committed to delivering a National Health Service that is fit for the future, and we recognise delivering high quality NHS healthcare requires the right infrastructure in the right places.Surgery expansion and new builds are considered by local integrated care boards (ICB’s) under the auspices of The National Health Service (General Medical Services - Premises Costs) Directions 2024, with further information available at the following link:https://assets.publishing.service.gov.uk/media/663cd8d2bd01f5ed32793867/nhs_general-medical-services-premises-costs_directions-2024.pdfThis guidance sets out the clear and transparent criteria for the application process and provide the ability for ICBs to invest capital into new primary care premises, which was not supported under earlier versions.To further support general practice contractors and ICBs, NHS England has published two documents, the Guide to the changes to primary care premises policy document, to provide an overview of the changes to the directions, and the Primary care capital grants policy document, to provide guidance on the investment of capital. Both documents are available, respectively, at the following two links:https://www.england.nhs.uk/long-read/guide-to-the-changes-to-primary-care-premises-policy/https://www.england.nhs.uk/long-read/primary-care-capital-grants-policy/For this financial year, 2025/26, the Government is providing £102 million of capital investment into upgrading the general practice estate across England in the form of the Utilisation and Modernisation Fund. Using targeted investment to create additional clinical capacity enabling practices to see more patients, boost productivity, and improve patient care. Most of the schemes will involve the repurposing of existing accommodation with a small number of modest surgery extensions.

What recent discussions NHS England has had with ICBs on the number of GP surgery expansion applications awaiting capital funding.

The Government is committed to delivering a National Health Service that is fit for the future, and we recognise delivering high quality NHS healthcare requires the right infrastructure in the right places.Surgery expansion and new builds are considered by local integrated care boards (ICB’s) under the auspices of The National Health Service (General Medical Services - Premises Costs) Directions 2024, with further information available at the following link:https://assets.publishing.service.gov.uk/media/663cd8d2bd01f5ed32793867/nhs_general-medical-services-premises-costs_directions-2024.pdfThis guidance sets out the clear and transparent criteria for the application process and provide the ability for ICBs to invest capital into new primary care premises, which was not supported under earlier versions.To further support general practice contractors and ICBs, NHS England has published two documents, the Guide to the changes to primary care premises policy document, to provide an overview of the changes to the directions, and the Primary care capital grants policy document, to provide guidance on the investment of capital. Both documents are available, respectively, at the following two links:https://www.england.nhs.uk/long-read/guide-to-the-changes-to-primary-care-premises-policy/https://www.england.nhs.uk/long-read/primary-care-capital-grants-policy/For this financial year, 2025/26, the Government is providing £102 million of capital investment into upgrading the general practice estate across England in the form of the Utilisation and Modernisation Fund. Using targeted investment to create additional clinical capacity enabling practices to see more patients, boost productivity, and improve patient care. Most of the schemes will involve the repurposing of existing accommodation with a small number of modest surgery extensions.

What the average time taken is for GP practices to secure funding for expansion through ICBs; and how his Department plans to reduce that time.

The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments.There is no average time for securing funding for expansions as each application is treated individually and multiple factors such as planning permission, recurrent revenue funding associated with the reimbursable elements, and legal agreements to protect the investment must be considered for each application.The Department continues to actively seek ways to improve and streamline our processes and we have announced our aim to fundamentally reform the financial system in the recently published 10-Year Health Plan. In parallel, a standard, simplified Grant Agreement has been developed and is being tested for capital schemes under £144,000. This is supporting a fast-track process for securing grant agreements for relatively low value schemes. We will continue to review all elements of the premises development approvals process to help improve productivity and reduce the overall time to secure approval and deliver expansions of primary care premises.