Written questions by Glindon.

What steps he is taking to increase the number of patients receiving dialysis at home.

Increasing access to home therapies is a priority for NHS England, and this is reflected in its inclusion in the Renal Transformation toolkit that was published in 2023, which recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.Commissioned renal clinical networks across England have included improving access to home therapies in their work plans as per the recommendations within the toolkit. NHS England’s national team supports renal clinical networks with the implementation of home dialysis transformation.Commissioned renal providers in England have a contractual obligation to reimburse the additional utility costs for patients who receive home haemodialysis therapy, as stipulated within the Haemodialysis to treat established renal failure performed in a patients home national service specification and the Paediatric medicine renal service specification. Reimbursement costs are managed directly between providers and patients, and therefore there is no central record of how many patients seek reimbursement. Further information on the Paediatric medicine renal service specification is available at the following link:https://www.england.nhs.uk/publication/paediatric-medicine-renal-service-specification/Renal clinical networks are working towards increasing home dialysis rates in line with the Renal Service Transformation Programme toolkit recommendations.

If he will make it his policy to ensure a minimum of 20% of dialysis patients in renal centres receive home dialysis.

Increasing access to home therapies is a priority for NHS England, and this is reflected in its inclusion in the Renal Transformation toolkit that was published in 2023, which recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.Commissioned renal clinical networks across England have included improving access to home therapies in their work plans as per the recommendations within the toolkit. NHS England’s national team supports renal clinical networks with the implementation of home dialysis transformation.Commissioned renal providers in England have a contractual obligation to reimburse the additional utility costs for patients who receive home haemodialysis therapy, as stipulated within the Haemodialysis to treat established renal failure performed in a patients home national service specification and the Paediatric medicine renal service specification. Reimbursement costs are managed directly between providers and patients, and therefore there is no central record of how many patients seek reimbursement. Further information on the Paediatric medicine renal service specification is available at the following link:https://www.england.nhs.uk/publication/paediatric-medicine-renal-service-specification/Renal clinical networks are working towards increasing home dialysis rates in line with the Renal Service Transformation Programme toolkit recommendations.

What estimate he has made of the number of people on home dialysis who do not receive reimbursement of the energy costs of that dialysis; and what assessment he has made of the potential impact of that number on the ability of his Department to shift care from hospital to community.

Increasing access to home therapies is a priority for NHS England, and this is reflected in its inclusion in the Renal Transformation toolkit that was published in 2023, which recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.Commissioned renal clinical networks across England have included improving access to home therapies in their work plans as per the recommendations within the toolkit. NHS England’s national team supports renal clinical networks with the implementation of home dialysis transformation.Commissioned renal providers in England have a contractual obligation to reimburse the additional utility costs for patients who receive home haemodialysis therapy, as stipulated within the Haemodialysis to treat established renal failure performed in a patients home national service specification and the Paediatric medicine renal service specification. Reimbursement costs are managed directly between providers and patients, and therefore there is no central record of how many patients seek reimbursement. Further information on the Paediatric medicine renal service specification is available at the following link:https://www.england.nhs.uk/publication/paediatric-medicine-renal-service-specification/Renal clinical networks are working towards increasing home dialysis rates in line with the Renal Service Transformation Programme toolkit recommendations.

Pursuant to the Answer of 7 January 2024 to Question 20962 on NHS: Staff, whether the engagement on the NHS workforce plan will include (a) a formal consultation separate to that on the 10 year health plan and (b) health charities as a key stakeholder group.

The refreshed Long Term Workforce Plan will deliver the transformed health service we will build over the next decade, and ensure patients get the treatment they need, when and where they need it.No formal statutory public consultation is planned. In the development of the plan, we will engage with a wide range of stakeholders, including health charities and trade unions, to ensure needs of staff and patients are considered.

If he will make an assessment of the potential impact of deterring adults who might otherwise smoke cigarettes from using flavoured vapes on public health.

The youth vaping call for evidence, published in 2023, demonstrated that vape flavours are one of the main reasons that vapes appeal to children. However, we recognise that vape flavours can also be a consideration for adult smokers seeking to quit smoking.That is why it is important we strike the balance between restricting vape flavours to reduce their appeal to young people, whilst ensuring vapes remain available for adult smokers as a smoking cessation tool. Before laying any regulations in Parliament, we will undertake a full public consultation to ensure we get this balance right, and consider the views of a range of stakeholders. We will also undertake a full impact assessment on any future flavour restrictions.The Tobacco and Vapes Bill includes regulation making powers to limit how nicotine products are displayed. These are also subject to consultation. Adult smokers will still be able to access vapes as well as other alternative methods to stop smoking. Vapes are commonly used alongside behavioural support within local Stop Smoking Services, helping thousands of adults each year to live healthier lives. In addition, our national Swap to Stop scheme is supporting adult smokers to swap cigarettes for vapes.

If he will take steps to help increase levels of awareness of the potential merits of switching to (a) vapes and (b) other alternatives to smoking among adult smokers, in the context of nicotine product display restrictions.

The youth vaping call for evidence, published in 2023, demonstrated that vape flavours are one of the main reasons that vapes appeal to children. However, we recognise that vape flavours can also be a consideration for adult smokers seeking to quit smoking.That is why it is important we strike the balance between restricting vape flavours to reduce their appeal to young people, whilst ensuring vapes remain available for adult smokers as a smoking cessation tool. Before laying any regulations in Parliament, we will undertake a full public consultation to ensure we get this balance right, and consider the views of a range of stakeholders. We will also undertake a full impact assessment on any future flavour restrictions.The Tobacco and Vapes Bill includes regulation making powers to limit how nicotine products are displayed. These are also subject to consultation. Adult smokers will still be able to access vapes as well as other alternative methods to stop smoking. Vapes are commonly used alongside behavioural support within local Stop Smoking Services, helping thousands of adults each year to live healthier lives. In addition, our national Swap to Stop scheme is supporting adult smokers to swap cigarettes for vapes.

Whether he plans to hold a separate consultation on the NHS workforce plan in addition to the consultation on the 10-Year Health Plan.

The refreshed Long Term Workforce Plan will deliver the transformed health service we will build over the next decade, and will ensure that patients get the treatment they need, when and where they need it.In the development of the plan, we will engage with a range of stakeholders to ensure the needs of staff and patients are considered.

Pursuant to the Answer to Question 12405 of 13 November 2024, whether he has had discussions with the community pharmacy sector on improving real-time communication on the availability of ADHD medications to patients.

No discussions have been held. The Department has worked with specialist clinicians, including those within the National Health Service, to develop management advice for the NHS. The guidance signposts all sectors to refer to the Specialist Pharmacy Service website for updates on the availability of attention deficit hyperactivity disorder (ADHD) medicines. The site is available at the following link:https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/The site is routinely updated to reflect the information we receive from United Kingdom suppliers regarding the availability of ADHD medicines in the UK.

If he will make an assessment of the potential impact of supply shortages for ADHD medication on the mental health of patients.

The Department is working closely with NHS England’s attention deficit hyperactivity disorder (ADHD) and medicines supply teams, to help resolve the supply issues and improve information for people with ADHD and clinicians.We are also supporting an independent cross-sector taskforce that NHS England has established to look at ADHD service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD, including timely access to services and support. The ADHD taskforce will also work closely with the Department for Education’s neurodivergence task and finish group.

Pursuant to the Answer of 11 November 2024 to Question 6227 Mental Health Services: Waiting Lists, if he will make an estimate of the proportion of people who (a) completed treatment and (b) waited less than 6 weeks for their first appointment for talking therapies in (i) Newcastle upon Tyne and (ii) North Tyneside in July 2024.

The following table shows the number of completed treatments and waiting times for a first appointment for Talking Therapies in the nearest equivalent areas, by sub integrated care board area, of NHS Newcastle Gateshead and NHS North Tyneside, in July 2024: NHS Newcastle GatesheadNHS North TynesideReferrals discharged during period1,315430Referrals discharged after completing at least two treatments625195Percentage of referrals discharged after completing at least two treatments47%45%Patient accessing their first treatment915400Patients accessing their first treatment in less than six weeks910375Percentage of patients accessing their first treatment in less than six weeks99%94%Source: NHS Talking Therapies Monthly Statistics, NHS England.

If his Department will take steps to improve the communication of the real-time availability of ADHD medications in pharmacies to patients.

The Department monitors and manages medicine supply at a national level so that stocks remain available to meet regional and local demand. Information on stock levels within individual pharmacies is not held centrally.To aid attention deficit hyperactivity disorder (ADHD) service providers, prescribers, and pharmacies, we have widely disseminated our communications and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients. Further information is available at the following link:https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/The team also regularly engages with patient groups to provide information on supply issues pertinent to them and their patients, and supports them with any patient communications they may wish to develop.

Pursuant to the Answer of 22 October 2024 to Question 9455 on Air Pollution: Poverty, if he will take steps to help tackle the impact of air pollution on people with a low income.

The Chief Medical Officers Annual report on Air Pollution (2022) demonstrated the increased health risks associated with exposure to air pollution among those living in areas of higher socio-economic deprivation. The Government are committed to reducing health inequalities and DHSC are supporting Defra to deliver their comprehensive and ambitious Clean Air Strategy which will include a series of interventions to reduce emissions so that everyone’s exposure to air pollution is reduced.

Pursuant to the answer of 22 October 2024 to Question 9455 on Air Pollution: Poverty, if he will take steps to reduce the number of schools in England that are in areas exceeding World Health Organisation guidelines for fine particulate matter (PM2.5) concentrations.

The Government is determined to improve air quality and protect children from the harms of pollution, and is committed to meeting the legal targets for air quality, including the targets recently set under the Environment Act 2021. The Department of Health and Social Care is working across Government to achieve this, including with the Department for Environment Food and Rural Affairs on their Clean Air Strategy to reduce emissions and reduce harms associated with air pollution.Local air quality is the responsibility of local authorities, who should prepare air quality action plans to ensure the level of pollutants is reduced, if it is not compliant with relevant limits. Local authorities are responsible for monitoring air quality in their areas and will decide where to undertake their monitoring, which may be around schools. The Government will continue to work with local authorities to support their work on improving air quality. Active Travel England and the Department for Transport are working on guidance for local authorities to help them implement School Streets vehicle access restrictions effectively.

What assessment his Department has made of the impact of air pollution on neighbourhoods with high levels of poverty.

Although air pollution can be harmful to everyone, some people are more affected because they live in a polluted area, are exposed to higher levels of air pollution in their day-to-day lives, or are more susceptible to health problems caused by air pollution, such as cardiovascular and respiratory diseases, lung cancer, and a shortened life expectancy.There is clear evidence that people with a low income are affected by air pollution in a number of different ways. The disadvantages that come about as a result of poor income add up, with deprived populations who are more likely to be in poor health, and are at greater risk from air pollution and its adverse health impacts. These inequalities can affect people throughout their lives, from the prenatal stage through to old age, particularly as deprived communities often have limited opportunities to improve their environment. Further information on pollution is available at the following link:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1124738/chief-medical-officers-annual-report-air-pollution-dec-2022.pdfA 2021 study by the UK Health Security Agency found that one-third of the schools in England were in areas exceeding World Health Organisation guidelines for fine particulate matter (PM2.5) concentrations. Schools with higher annual mean PM2.5 concentrations are more likely to have a high deprived pupil intake and be in neighbourhoods with high levels of child income deprivation compounding existing socioeconomic disadvantages.