Written questions by Dowden.

What steps his Department is taking to promote NHS innovation in nano surgery.

As set out in the 10-Year Health Plan and Life Sciences Sector Plan, the Department encourages innovation in the health sector that helps to support the three big shifts in healthcare: moving care from hospitals to communities; transitioning from analogue to digital; and focusing on prevention over treatment.The Department is actively supporting the development and evaluation of game-changing innovations as well as the adoption of technologies to give our world leading clinicians the technology and skills to improve outcomes for patients.Improving innovation, adoption, and procurement of game-changing technology, including nano surgery, will help the National Health Service secure the best possible outcomes for patients whilst also delivering greater value-for-money and unlocking further economic growth. In addition, the National Cancer Plan will include further details on how we will improve outcomes for cancer patients, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately drive up this country’s cancer survival rates.The Department funds research through the National Institute for Health and Care Research (NIHR). As well as funding research directly through NIHR programmes, the Department also funds NIHR infrastructure which are centres of excellence and collaborations, services, and facilities to support health and care research.The NIHR research infrastructure drives innovation through research across a range of health and care areas, including nano surgery. For example, the Surgical and Perioperative Care Translational Research Collaboration brings together NIHR infrastructure to develop new surgical interventions, improving patient safety and patient care before and after surgery.The NIHR HealthTech Research Centres (HRCs) work with industry to develop medical devices, diagnostics, and digital technologies. The NIHR Accelerated Surgical Care HRC’s focus is on minimally invasive therapies which enable surgical care to be delivered with greater precision, minimal trauma, and improved outcomes.

What steps he is taking to increase access to continuous glucose monitors for people with diabetes.

There are currently over 200,000 people living with diabetes in England who benefit from real-time continuous glucose monitoring (CGM) In order to help integrated care boards (ICBs) improve access to CGM to eligible people, data is now collected as part of the National Diabetes Audit. NHS England routinely publishes this data in the NDA Core Quarterly dashboard in 2025/26, which provides the data insights ICBs require, including data on CGM uptake, variation, and health inequalities. Further information on this is available at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit

What progress his Department has made on the phased implementation period for access to hybrid closed-loop technology for people with type 1 diabetes.

NHS England has developed a five-year national strategy with guidance to National Health Service providers on the phased uptake approach of hybrid closed loop (HCL) systems. Rollout started in April 2024 with pregnant women, children, young people, those planning to become pregnant, and adults already using pumps who want to transition to an HCL system.So far under the strategy, over 600 pregnant women with type 1 diabetes have been provided with an HCL.

What steps he is taking to improve the (a) quality and (b) provision of NHS wheelchairs.

Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services. It is therefore the responsibility of ICBs to review and assess the quality of the provision of their commissioned National Health Service wheelchair services.NHS England supports ICBs to commission effective, efficient and personalised wheelchair services. Since July 2015, NHS England has collected quarterly data from clinical commissioning groups, now ICBs, on wheelchair provision, including waiting times, to enable targeted action if improvement is required.NHS England is taking steps to reduce regional variation in the quality and provision of NHS wheelchairs, and to support ICBs to reduce delays in people receiving timely intervention and wheelchair equipment. This includes publishing a Wheelchair Quality Framework on 9 April 2025 which sets out quality standards and statutory requirements for ICBs, such as offering personal wheelchair budgets. The framework is available at the following link:https://www.england.nhs.uk/long-read/wheelchair-quality-framework/

What steps he is taking to improve the (a) quality and (b) provision of NHS wheelchairs by AJM Healthcare.

The safety of all patients, whether they are treated in the National Health Service or the independent sector, is a top priority for the Government.Integrated care boards (ICBs) are responsible for the provision and commissioning of local wheelchair services, based on the needs of their local population. NHS England supports ICBs to commission effective, efficient, and personalised wheelchair services and to reduce delays in people receiving timely intervention and wheelchair equipment.NHS England is aware there have been several separate complaints about the quality of services provided by AJM Healthcare, which are being dealt with on an individual basis by the ombudsman’s office. NHS England is taking steps to reduce regional variation in the quality and provision of NHS wheelchairs, and to support ICBs to reduce delays in people receiving timely intervention and wheelchair equipment. This includes publishing a Wheelchair Quality Framework on 9 April 2025, which sets out quality standards relevant to all suppliers regardless of Care Quality Commission registration status, and statutory requirements for ICBs. The framework is available at the following link:https://www.england.nhs.uk/long-read/wheelchair-quality-framework/There are a range of providers of NHS wheelchair services across England. ICBs are responsible for monitoring service provision and effectively managing contracts with their commissioned providers. Therefore, we would encourage those with concerns regarding the service and support provided by an NHS wheelchair service to raise them directly with the local ICB.

What steps his Department plans to take to (a) tackle, (b) prevent and (c) monitor poor quality care in council-commissioned care homes.

The Care Quality Commission (CQC) is the independent regulator for health and social care in England. The CQC monitors, inspects, and regulates adult social care services, including council-commissioned care homes, to make sure they meet fundamental standards of quality and safety. Inspection reports on individual providers are made publicly available.Where concerns on quality or safety are identified, the CQC uses a range of regulatory and enforcement powers to take action to ensure the safety of the people drawing on care and support.This could include using requirement notices to highlight areas that need improvement, or placing adult social care providers into special measures to closely supervise the quality of their care. In cases of significant concern, the CQC can take action that could lead to the removal of a provider’s registration or, in the most serious cases, take criminal action.The CQC also assesses local authorities’ delivery of their duties under Part 1 of the Care Act 2014. This includes the local authority’s duty to work closely with local providers to ensure high quality services that put the wellbeing of the people who draw on care at the centre of decisions. Local authorities should also keep contracts under review to confirm that care requirements are being met, and to seek to continuously improve the quality, effectiveness, and efficiency of services.I recently met with Sir Julian Hartley on 14 March 2025, where we discussed the CQC’s recent challenges and how we will continue working closely together on key priorities.

What steps he plans to take to tackle losses to community pharmacies arising from delays in price concessions and drug tariffs.

The Drug Tariff is updated monthly and sets out reimbursement prices to be paid to pharmacy contractors for medicines dispensed. When the market price of a generic medicine suddenly increases, concessionary prices can be granted in that month, increasing the reimbursement price above the Drug Tariff price, with the aim of mitigating pharmacy contractors dispensing at a loss. If the medicine margin survey indicates that, despite a concessionary price, there was a significant under payment for a specific product, there is a provision known as a retrospective top-up payment for concessionary prices, which provides an additional payment to contractors for those products. A quarterly medicine margin survey also ensures that pharmacy contractors are reimbursed enough overall for the medicines they dispense.

Whether he plans to expand the Pharmacy First scheme.

Pharmacies play a vital role in our healthcare system. The Government is committed to expanding the role of pharmacies and to better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.Pharmacy First has built on existing services to increase the clinical scope of the treatment and advice patients can receive. The conditions treated under the Pharmacy First offer will continue to be kept under review.The Government recently resumed its consultation with Community Pharmacy England regarding funding arrangements.

What steps he plans to take to support community pharmacies.

Pharmacies play a vital role in our healthcare system. The Government is committed to expanding the role of pharmacies and to better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.Pharmacy First has built on existing services to increase the clinical scope of the treatment and advice patients can receive. The conditions treated under the Pharmacy First offer will continue to be kept under review.The Government recently resumed its consultation with Community Pharmacy England regarding funding arrangements.

When his Department plans to next review the NHS Car Parking guidance.

NHS Car Parking guidance was last updated in October 2022 under the previous government. The Department has no plans to review the guidance. Free hospital car parking is available to groups most in-need, including National Health Service staff working overnight. All trusts that charge for hospital car parking have implemented this policy.

Whether his Department plans to review the NHS Car Parking guidance.

NHS Car Parking guidance was last updated in October 2022 under the previous government. The Department has no plans to review the guidance. Free hospital car parking is available to groups most in-need, including National Health Service staff working overnight. All trusts that charge for hospital car parking have implemented this policy.

What steps his Department plans to take to support NHS services in Hertfordshire, in the context of his Department's review of the New Hospital Programme.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, set out a credible and deliverable plan for the new hospital schemes in the New Hospital Programme (NHP) on 20 January 2025, following the conclusion of the review of the NHP. The plan for implementation was laid in the House Library and published on the GOV.UK website, and is available at the following link:https://www.gov.uk/government/publications/new-hospital-programme-review-outcomeAs confirmed in this publication, the scheme for Watford General Hospital is now part of wave two of the NHP. Construction of the main hospital build is expected to commence between 2032 and 2034.In the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer, announced that health capital spending will increase to £13.6 billion in 2025/26. Further details on this funding will follow at the earliest opportunity, including local capital allocations and national capital programmes for 2025/26, as part of the National Health Service’s planning guidance. Budgets for future years will be confirmed as part of the upcoming Spending Review. The state of the NHS estate and safety impacts will be considered as part of this.The Hertfordshire and West Essex Integrated Care Board received almost £65 million in operational capital funding in 2023/24, and the West Hertfordshire Teaching Hospitals NHS Trust has also been allocated £50 to 60 million from NHS funding for planned care services at St. Albans City Hospital.

What progress he has made on the New Hospital Programme Review, in the context of Watford General Hospital.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, set out a credible and deliverable plan for the new hospital schemes in the New Hospital Programme (NHP) on 20 January 2025, following the conclusion of the review of the NHP. The plan for implementation was laid in the House Library and published on the GOV.UK website, and is available at the following link:https://www.gov.uk/government/publications/new-hospital-programme-review-outcomeAs confirmed in this publication, the scheme for Watford General Hospital is now part of wave two of the NHP. Construction of the main hospital build is expected to commence between 2032 and 2034.In the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer, announced that health capital spending will increase to £13.6 billion in 2025/26. Further details on this funding will follow at the earliest opportunity, including local capital allocations and national capital programmes for 2025/26, as part of the National Health Service’s planning guidance. Budgets for future years will be confirmed as part of the upcoming Spending Review. The state of the NHS estate and safety impacts will be considered as part of this.The Hertfordshire and West Essex Integrated Care Board received almost £65 million in operational capital funding in 2023/24, and the West Hertfordshire Teaching Hospitals NHS Trust has also been allocated £50 to 60 million from NHS funding for planned care services at St. Albans City Hospital.

With reference to the New Hospital Programme review, when the (a) options and (b) recommendations for Watford General Hospital will be published; and when he plans to announce which hospitals will be prioritised.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, set out a credible and deliverable plan for the new hospital schemes in the New Hospital Programme (NHP) on 20 January 2025, following the conclusion of the review of the NHP. The plan for implementation was laid in the House Library and published on the GOV.UK website, and is available at the following link:https://www.gov.uk/government/publications/new-hospital-programme-review-outcomeAs confirmed in this publication, the scheme for Watford General Hospital is now part of wave two of the NHP. Construction of the main hospital build is expected to commence between 2032 and 2034.In the 2024 Autumn Budget, my Rt. Hon. Friend, the Chancellor of the Exchequer, announced that health capital spending will increase to £13.6 billion in 2025/26. Further details on this funding will follow at the earliest opportunity, including local capital allocations and national capital programmes for 2025/26, as part of the National Health Service’s planning guidance. Budgets for future years will be confirmed as part of the upcoming Spending Review. The state of the NHS estate and safety impacts will be considered as part of this.The Hertfordshire and West Essex Integrated Care Board received almost £65 million in operational capital funding in 2023/24, and the West Hertfordshire Teaching Hospitals NHS Trust has also been allocated £50 to 60 million from NHS funding for planned care services at St. Albans City Hospital.

How much of the NHS funding announced in the Autumn Budget 2024, HC 295, will be allocated to ambulance services.

The information requested is not held by the Department. The future allocation of National Health Service funding announced in the Autumn Budget will be decided by NHS England.

If his Department will make an assessment of the potential merits of extending NHS Outer London Weighting to (a) Hertsmere and (b) Watford.

It is for the Pay Review Bodies to make recommendations on the future geographic coverage of high-cost area supplements, and on the value of such supplements. As this is reflected in terms and conditions of service, any changes would need to be collective...

If he will increase the staffing budget for the East of England Ambulance Service.

The allocation of National Health Service funding, including local staffing budgets, is set by NHS England.

What assessment his Department has made of the adequacy of GP provision in Hertsmere.

We know that patients are finding it harder than ever to see a general practitioner (GP) and we are committed to fixing the the crisis in the National Health Service, to ensure that patients receive the care they deserve, and to secure the long-term sustainability of the NHS.We will increase the proportion of funding for GPs and shift the focus of the NHS out of hospitals, and into the community. We have committed to end the 8:00am scramble for GP appointments by introducing a modern booking system. Additionally, the Government will train thousands more GPs across the country to increase capacity, secure the future pipeline of GPs, and take the pressure off those currently working in the system.We will introduce and trial new Neighbourhood Health Centres to bring vital health and care services together under one roof, ensuring healthcare is closer to home and that patients receive the integrated, patient centered services we all want to see.Hertsmere sits within the NHS Hertfordshire and West Essex Integrated Care Board, where the percentage of appointments delivered within two weeks of booking is 5.6% lower than the national average.We are pleased to announce that newly qualified GPs will be included in the Additional Roles Reimbursement Scheme (ARRS) as part of an initiative to address GP unemployment with additional funding over 2024/25. This is a step on the journey while the Government works with the profession to identify longer term solutions to GP unemployment and general practice sustainability.

Whether he (a) has reviewed and (b) plans to review the (i) provision and (ii) location of (A) inpatient and (B) outpatient health services in South Hertfordshire.

There are currently no plans to review the provision and location of inpatient and outpatient health services in South Hertfordshire. Integrated care boards are responsible for ensuring that the provision and location of both inpatient and outpatient health services meets the demand of their local population.