Department of Health and Social Care

Depression affects approximately one third of people with stroke, and stroke services in the National Health Service are very aware of the impact this can have on the quality of life and level of independence of people who experienced a stroke, and the importance of understanding through measurement which people are affected, to support appropriate management.

The National Clinical Guideline for Stroke 2023 recommends that people with stroke should be routinely screened for anxiety and depression using standardised tools, the results of which should be used alongside other sources of information to inform clinical formulation of treatment and support needs.

The latest published Sentinel Stroke National Audit Programme (SSNAP) data, from October to December 2023, showed that 92.4% of stroke patients were screened for mood disturbances, including depression, in hospital. 75% of stroke patients who were followed up at six months post stroke also had a mood screen, with 53% of patients receiving the psychological support needed.

NHS England is driving implementation of the National Service Model for an Integrated Community Stroke Service (ICSS) with a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work, and improved quality of life. From July 2024, the SSNAP will record the amount of psychological rehabilitation provided to patients, and measure changes in quality of life over time.

The current contract with NEC Software Solutions for centralising the Medical Device Outcome Registry, National Joint Registry, and National Vascular Registry is £969,544. Further information is available at the GOV.UK contracts finder, at the following link:

https://www.contractsfinder.service.gov.uk/Notice/bb2b90d1-c52c-4388-9159-7e8b8dce3c32

It is not Government policy for the National Health Service to refer to ‘people who have ovaries’ and this phraseology has not been market tested. We have been clear that biological sex matters and it is important to use language that recognises the separate health and biological needs of men and women.

For all sex-specific conditions, we expect the language used to put biological sex, for example “women”, front and centre, with biologically-relevant information relating to specific organs or hormones secondary.

Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.

The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.

In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.

The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.

From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.

NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.

Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.

The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.

In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.

The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.

From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.

NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.

Integrated care boards (ICBs) are responsible for determining the level of locally available, National Health Service funded palliative and end of life care, including hospice care. ICBs are responsible for ensuring that the services they commission meet the needs of their local population.

The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.

In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties, and making clear reference to the importance of access to services.

The Department and NHS England, alongside key partners, will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, on an ongoing basis, in order to understand the issues they face, including that of future funding pressures. The Department is in ongoing discussions with NHS England, including its National Clinical Director, about the oversight and accountability of National Health Service palliative and end of life care commissioning.

From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. These national meetings will provide an additional mechanism for supporting ICBs in continuing to improve palliative and end of life care for their local population.

NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities. Additionally, the National Institute for Health and Care Research has established a new Policy Research Unit to build an evidence base on palliative and end of life care, with a specific focus on inequalities.

The National Health Service website and the NHS App are our main digital tools available to citizens, to support them in accessing services and making decisions about their health. Clinicians across the NHS also support patients’ health literacy by providing clear information, increasing patients’ knowledge, and sharing decision-making on their care.

Additionally, through the Voluntary Community Social Enterprise (VCSE) Health and Wellbeing Programme, the Department, NHS England, and the UK Health Security Agency work together with VCSE organisations to drive transformation of health and care systems, promote equality, address health inequalities, and help people, families, and communities to achieve and maintain wellbeing. The current projects include increasing health literacy through intersectional considerations at the end of life, digital inclusion, and barriers for those likely to be in the last year of life without a life-limiting diagnosis.

The Government recognises that access to high-quality palliative and end of life care can make all the difference to individuals and their loved ones. NHS England meets regularly with regional and system leaders, providing a forum for the sharing of best practice. In addition, there is a palliative and end of life care workspace available on the FutureNHS Collaborative Platform, which includes a range of resources, case studies, and discussion fora, with access to the platform available for anyone with a NHS.net email account.

NHS England has developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, enabling integrated care boards (ICBs) to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.

As of April 2024, NHS England is including palliative and end of life care in the list of topics for regular performance discussions between national and regional leads. These meetings will provide an additional mechanism for supporting ICBs to continue improving palliative and end of life care for their local population.

The Ambitions Framework, refreshed by the National Palliative and End of Life Care Partnership, which is made up of NHS England and 34 partner organisations with experience of, and responsibility for, end of life care, sets out the vision to improve end of life care through partnership and collaborative action between organisations at local level throughout England, by setting out six key ambitions.

Furthermore, the National Institute for Health and Care Excellence (NICE) has published guidance and quality standards on end of life care for adults, and children and young people. These are based on best practice in developing and delivering care and, while not statutory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities.

Ministers and officials in the Department have regular conversations with representatives of local government, including the Local Government Association and the Association for Directors of Adult Social Services, regarding the costs of meeting the needs of adults who draw on care and support. The Department regularly engages with local authorities, who are responsible for assessing eligibility for financial assistance as set out in the Care Act, to understand the impact charging policy has on individuals who draw on care. The Department also regularly engages with individual local authorities to better understand their financial plans for commissioning and delivering adult social care.

The National Institute for Health and Care Excellence’s (NICE) guideline, Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published in October 2021, outlines the expectations for inpatient care for patients with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The guidance states that where possible, patients with ME should be provided with a single room, and that factors such as the level of lighting and sound should be taken into consideration, and necessary adjustments made.

It is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. Whilst guidelines are not mandatory, clinicians and commissioners are expected to take them fully into account when designing services that meet the needs of their local population. The NICE promotes its guidance via its website, newsletters, and other media.

The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff in providing better care and improving patient outcomes. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.

We have finished consulting on My Full Reality, the cross-Government interim delivery plan on ME, which seeks to improve the experiences and outcomes of people living with this condition. We are in the process of analysing the results of the consultation. The views and experiences gathered through this consultation will be used to build a picture of how well the interim delivery plan identifies and meets the needs of the ME community, and to highlight any significant gaps where further action may be necessary. We will publish a summary of the consultation responses, which will inform the final delivery plan being published later this year, in due course.

The National Institute for Health and Care Excellence’s (NICE) guideline, Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published in October 2021, outlines the expectations for inpatient care for patients with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The guidance states that where possible, patients with ME should be provided with a single room, and that factors such as the level of lighting and sound should be taken into consideration, and necessary adjustments made.

It is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. Whilst guidelines are not mandatory, clinicians and commissioners are expected to take them fully into account when designing services that meet the needs of their local population. The NICE promotes its guidance via its website, newsletters, and other media.

The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff in providing better care and improving patient outcomes. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.

We have finished consulting on My Full Reality, the cross-Government interim delivery plan on ME, which seeks to improve the experiences and outcomes of people living with this condition. We are in the process of analysing the results of the consultation. The views and experiences gathered through this consultation will be used to build a picture of how well the interim delivery plan identifies and meets the needs of the ME community, and to highlight any significant gaps where further action may be necessary. We will publish a summary of the consultation responses, which will inform the final delivery plan being published later this year, in due course.

The National Institute for Health and Care Excellence’s (NICE) guideline, Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management, published in October 2021, outlines the expectations for inpatient care for patients with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The guidance states that where possible, patients with ME should be provided with a single room, and that factors such as the level of lighting and sound should be taken into consideration, and necessary adjustments made.

It is the duty of clinicians to keep themselves appraised of best practice, in particular guidance issued by the NICE. Whilst guidelines are not mandatory, clinicians and commissioners are expected to take them fully into account when designing services that meet the needs of their local population. The NICE promotes its guidance via its website, newsletters, and other media.

The Department is working with NHS England to develop an e-learning course on ME for healthcare professionals, with the aim of supporting staff in providing better care and improving patient outcomes. The Medical Schools Council will promote the NHS England e-learning package on ME to all United Kingdom medical schools, and encourage medical schools to provide undergraduates with direct patient experience of ME.

We have finished consulting on My Full Reality, the cross-Government interim delivery plan on ME, which seeks to improve the experiences and outcomes of people living with this condition. We are in the process of analysing the results of the consultation. The views and experiences gathered through this consultation will be used to build a picture of how well the interim delivery plan identifies and meets the needs of the ME community, and to highlight any significant gaps where further action may be necessary. We will publish a summary of the consultation responses, which will inform the final delivery plan being published later this year, in due course.

The Government will shortly be consulting on specific changes to the NHS Constitution, in addition to seeking views on the NHS Constitution as a whole. Feedback submitted will be considered during the post-consultation review. The Government will endeavour to issue a response 12 weeks after the consultation has closed.

On 22 February 2024, we launched the Baby Loss Certificate service, fulfilling our commitment in the Women’s Health Strategy. We recognise that some people will wish to obtain a certificate for a baby loss that happened in the past. It is currently open to pregnancy losses since 1 September 2018, and we will extend this to earlier losses as soon as we can.

NHS England remains committed to the continued development and improvement of all services, including neuropsychiatry. Neuropsychiatry covers a broad spectrum of mental health support, for people with a broad spectrum of neurological conditions, and as such, provision of neuropsychiatry falls within the care pathway of a range of services.

The provision of neuropsychiatry is included in, and will be strengthened within, the updated neurology service specification, neurosurgery specification, and complex rehabilitation service specification. The requirement and scope of a standalone neuropsychiatry service specification is being discussed with the Royal College of Psychiatry and mental health colleagues.

The Neurology Clinical Reference Group (CRG) will continue to lead this work and take forward discussions with the Royal College of Psychiatry, which is represented on both the Neurology CRG and Complex Rehabilitation and Disability CRG, and is contributing to the development of the service specifications listed above.

My Rt hon. Friend, the Secretary of State for Health and Social Care has regular discussions on a wide range of matters, with a wide range of people. NHS England is establishing a new attention deficit hyperactivity disorder (ADHD) taskforce alongside the Government, to improve care for people living with the condition. The new taskforce will bring 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, and help provide a joined-up approach in response to concerns around rising demand for assessments and support. NHS England will continue to engage widely throughout the process, and will engage with the devolved administrations as appropriate.

No specific formal assessment has been made. Gender medicine is a highly specialised field of medicine, and NHS England are actively working to recruit more staff for the new regional children and young people gender identity services. NHS England has also been working closely with other professional bodies to develop tailored training for these professionals. NHS England will commission the required professional training curriculum and competencies framework, not just for staff working in the new gender services, but also for clinicians working in secondary, primary, and community care. It is expected that this will also help to increase the support for children and young people, ensuring they receive a more holistic model of care.

The UK Health Security Agency continues to monitor international reporting. In the United States, as of 31 January 2024, maternal immunisation was 17.9%. By February 2024, 43% of infants under eight months old had received a dose of nirsevimab.

In Galicia, Spain, 92.9% of 5,357 infants born between 25 September 2023 and 4 February 2024 had nirsevimab, plus 79.7% of 5,823 in a catch-up programme. The peak of hospitalisation rate in infants under six months old was 102 per 100,000, for season 2023 to 2024 during the week starting 27 November 2023 compared to a median of 776 for seasons 2017 to 2018, 2018 to 2019 and 2019 to 2020, peaking during the first week of January 2024.

In Luxembourg, 84% of 1,524 infants born in hospital between early October and mid-December 2023 received nirsevimab. Luxembourg observed a decrease in hospitalisation in infants under six months old of 69% between the 2022 to 2023 and 2023 to 2024 respiratory syncytial virus seasons.

The Levelling Up the United Kingdom white paper sets out the Government’s ambition to improve living standards and wellbeing across the UK, invest in communities, and improve public services. It sets mutually reinforcing levelling up missions to focus Government action, including a health mission to narrow the gap in healthy life expectancy by 2030, and increase healthy life expectancy by five years by 2035.

The Government has published a 10-year drug strategy and is investing an extra £532 million between 2022/23 to 2024/25 to improve drug and alcohol treatment and recovery services. This funding is being used by local authorities to create places for an additional 54,500 people in drug and alcohol treatment services and bolster the workforce, seeking to prevent nearly 1,000 deaths. This funding is being targeted to areas of highest need first.

The Department is increasingly focusing on supporting local areas, including better meeting the needs of vulnerable groups. Current work includes: providing targeted support to local areas; enhancing data tools to better inform local needs assessments; supporting workforce development; implementation of the commissioning quality standard; and sharing good practice. Implementation support will adapt over the course of the 10-year strategy in response to need, to ensure we reach the drug strategy goals.

We also published our new Suicide Prevention Strategy for England in September 2023, setting out the actions we will take to save lives and reduce suicides within the next few years, and have set out our intention in the strategy to write guidance for local areas to support them in aligning their own strategies with the national strategy. We have also established a £10 million Suicide Prevention Grant Fund to run from 2023 to March 2025, and on 4 March 2024 we announced the 79 organisations across the country that have been allocated funding. We have also launched a new nationwide, near real-time suspected suicide surveillance system, that will improve the early detection of, and timely action to, address changes in suicide rates or trends.

The Levelling Up the United Kingdom white paper sets out the Government’s ambition to improve living standards and wellbeing across the UK, invest in communities, and improve public services. It sets mutually reinforcing levelling up missions to focus Government action, including a health mission to narrow the gap in healthy life expectancy by 2030, and increase healthy life expectancy by five years by 2035.

The Government has published a 10-year drug strategy and is investing an extra £532 million between 2022/23 to 2024/25 to improve drug and alcohol treatment and recovery services. This funding is being used by local authorities to create places for an additional 54,500 people in drug and alcohol treatment services and bolster the workforce, seeking to prevent nearly 1,000 deaths. This funding is being targeted to areas of highest need first.

The Department is increasingly focusing on supporting local areas, including better meeting the needs of vulnerable groups. Current work includes: providing targeted support to local areas; enhancing data tools to better inform local needs assessments; supporting workforce development; implementation of the commissioning quality standard; and sharing good practice. Implementation support will adapt over the course of the 10-year strategy in response to need, to ensure we reach the drug strategy goals.

We also published our new Suicide Prevention Strategy for England in September 2023, setting out the actions we will take to save lives and reduce suicides within the next few years, and have set out our intention in the strategy to write guidance for local areas to support them in aligning their own strategies with the national strategy. We have also established a £10 million Suicide Prevention Grant Fund to run from 2023 to March 2025, and on 4 March 2024 we announced the 79 organisations across the country that have been allocated funding. We have also launched a new nationwide, near real-time suspected suicide surveillance system, that will improve the early detection of, and timely action to, address changes in suicide rates or trends.

We remain committed to promoting a healthy diet for adults and children and are delivering an ambitious programme of work to create a healthier environment to help people make healthy food choices to improve health and to tackle diet related ill health. There are a range of measures in place to support improving diets, promoting physical activity and reducing obesity.

Regulations on out of home calorie labelling for food sold in large businesses, including restaurants, cafes and takeaways, came into force in April 2022. Restrictions on the placement of products high in fat, sugar or salt in key selling locations, came into force on 1 October 2022.  We will be implementing restrictions on the sale of less healthy products by volume price such as ‘3 for 2’ and will introduce restrictions on the advertising of less healthy products before 9pm on TV and paid for less healthy product advertising online from 1 October 2025.

We are working with the food industry to make further progress on reformulation and ensure it is easier for the public to make healthier choices. The Food Data Transparency Partnership will help enable and encourage food companies to voluntarily demonstrate progress on the healthiness of their sales.

The Government continues to promote the Eatwell Guide principles through the NHS.UK website and government social marketing campaigns such as Better Health Healthier Families and Start for Life. We are also supporting more than three million children through the Healthy Foods Schemes and helping schools boost physical activity to help children maintain a healthy weight and good overall health through the Primary School PE and Sport Premium and the School Games Organiser Network.

We are continuing to support local authorities to improve the uptake of the NHS Health Check, England's cardiovascular disease prevention programme. The NHS Health Check helps to prevent a range of conditions including heart disease and type 2 diabetes. Each year the programme engages over 1 million people and prevents around 400 heart attacks or strokes.

The Food Data Transparency Partnership’s (FDTP) Health Working Group (HWG) has been testing the effectiveness and quality of potential standardised metrics that food and drink companies can use to report on the healthiness of their sales. This is an important part of government’s strategy to address poor diet and reduce obesity and was restated in the Major Conditions Strategy interim report August 2023.

Once a recommended set of metrics and reporting guidance has been produced and approved by Ministers, the expectation is that businesses who voluntarily report will all follow this standardised approach.

A key commitment of the HWG is timely and transparent communication so that wider food sector stakeholders can input into each stage of the process in order to ensure recommendations around comparability and enforcement will be as viable and effective as possible. Alongside engagement with industry, the FDTP also regularly engages civil society organisations and investor groups to gather and integrate wider feedback into discussions. Summaries of these HWG discussions are published online on the FDTP GOV.UK page.

The United Kingdom welcomes the Pandemic Accord as an opportunity to strengthen global health security. Improving indoor air quality remains an important issue in public health. However, as the Accord aims to establish a high-level framework for pandemic prevention, preparedness and response, we have pursued action on this specific issue in other multilateral settings.

The UK continues to support international improvements to indoor air pollution through its engagement with the World Health Organization (WHO). For example, the UK Health Security Agency (UKHSA) contributed to WHO projects in 2020 and 2022 to assess combined exposure to multiple chemicals in indoor air in schools. UKHSA continues to work with the International Society on Indoor Air Quality and Climate on the development of an open database on international indoor environmental quality guidelines. The database aims to be actively used by researchers, practitioners, and policymakers across the world.

Moreover, the UK was a strong advocate for action to improve indoor air quality at last year’s United Nations General Assembly. We worked with international partners on this issue during the High-Level Meeting on Universal Health Coverage. The UK was supportive of reference being made to the health impacts of indoor air pollution, which was subsequently adopted in the meeting’s political declaration on 5 October 2023, and is available on the United Nations website in an online-only format.

We published our Delivery plan for recovering access to primary care in May 2023, which sets out how we are moving toward a ‘Modern General Practice’ model. This plan is backed by £240 million of retargeted funding going to provide digital services with the goal of increasing access. A copy of the plan is attached.

The sole method for general practices (GPs) to procure these digital services is via NHS England procurement frameworks, which list pre-approved suppliers for digital and IT services. This is to ensure consistency in service provisions, as each supplier must meet a set of requirements to be entered into a framework.

Each practice will run a procurement for these services and will select a supplier based on their differing specifications for how the IT systems will best meet their patients’ needs. Each supplier will offer varied services with varied benefits, including capabilities which allow patients and service users to request and receive support relating to healthcare concerns, at a time and place convenient for them.

As of March 2024, 93% of general practices now have digital telephony systems, this has enabled GP teams to manage multiple calls and helping to end the ‘8am rush’ for appointments. Trials show that this has increased patients’ ability to get through to their practice by almost a third.

Suppliers of magnetic resonance imaging (MRI) scanners are moving to a sealed helium solution, whereby the helium required to cool the magnet is approximately 0.5% of the current levels. These sealed systems will also ensure MRI scanners do not require further helium to be added during years of operational use.

Furthermore, suppliers are now replacing MRI scanners without requiring the magnet to be replaced, though this is only available for the first replacement cycle, whereby the scanner is fully replaced, but the existing magnet and helium are retained.

With regards to the Department, as set out in the recent Medical Technology Strategy: One Year On publication, the Design for Life Programme has been stood up to work with industry, the health and care sector, and academic partners to develop medical technology systems that support reuse, remanufacture, and material recovery becoming the default. This includes developing regulatory, commercial, digital, and policy environments that support this aim. The Department’s intention is to publish a roadmap later this year to articulate our relevant findings and plans moving forward.

In March 2021, the Government published The best start for life: a vision for the 1,001 critical days, a copy of which is attached. This vision sets out six action areas for improving support for families during the 1,001 critical days to ensure every baby in England is given the best possible start in life, regardless of background.

The Government is investing approximately £300 million to improve support for families through the joint Department of Health and Social Care and Department for Education Family Hubs and Start for Life Programme. The programme is implementing many elements of the Best Start for Life Vision and is delivering a step change in outcomes for babies, children and their parents and carers in 75 local authorities in England, including those with high levels of deprivation. This investment includes £100 million for bespoke perinatal mental health and parent-infant relationship support. Many local authorities without funding have also chosen to implement elements of the vision.

The introduction and adoption of new immunisation programmes and achieving high uptake across all immunisation programmes remains a high priority for the Government. We achieve high uptake for both life-course and seasonal vaccinations, with over 90% for pre-school diphtheria, tetanus, and pertussis and among the highest in the world for flu vaccination. The NHS COVID-19 vaccination programme has been the biggest vaccine drive in the history of the National Health Service, implementing the largest volume of new vaccines in the shortest time, and repeatedly with boosters. 157.5 million COVID-19 vaccinations were delivered in England from December 2020 to the end of January 2024. However, over the last decade, performance across routine immunisation programmes has been in decline and continued variation in uptake and coverage between different communities reflects wider health inequalities.

In response to these challenges, the NHS vaccination strategy builds on lessons learnt from the pandemic and the success of our routine immunisation programmes. It aims to maximise uptake and coverage of vaccinations across all communities, improving uptake to save more lives.

The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care sets out in paragraph 185 that, where an individual is eligible for NHS Continuing Healthcare (CHC), the integrated care board (ICB) is responsible for care planning, commissioning services, and case management. The ICB is responsible for planning strategically, specifying outcomes, procuring services, and managing demand and provider performance in relation to CHC. The services commissioned must include ongoing case management, including review or reassessment of the individual’s needs.

NHS England holds ICBs accountable, and engages with them to ensure that they discharge their functions via timely and well-established assurance mechanisms. The national framework also sets out that those in receipt of CHC continue to be entitled to access to the full range of primary, community, secondary, and other health services.

The Care Act (2014) requires local authorities to deliver a wide range of sustainable, high-quality care and support services, including support for unpaid carers. Local authorities are required to undertake a Carer’s Assessment for any unpaid carer who appears to have a need for support, and to meet their eligible needs on request from the carer.

Through the Accelerating Reform Fund (ARF), we are investing £42.6 million for innovative local projects focused on transforming the care sector. The purpose of the ARF is to support two or more projects in each area, with at least one of those having a particular focus on unpaid carers. More than half of the projects, and at least one in each integrated care system area, are focused on identifying, recognising, and supporting unpaid carers.

NHS England’s Advancing Mental Health Equalities Strategy launched in September 2020, to assess inequalities in access, including those based on gender, and to set out guidance on how services should be taking this into account.

Fundamentally, this strategy aims to ensure that access to the timely, high-quality mental healthcare as described in the NHS Long Term Plan is equitable, by equipping systems with the tools and enablers they need to bridge the gaps between people, such as men, faring worse than others in mental health services.

Middle-aged men are identified in Suicide prevention in England: 5-year cross-sector strategy, as a priority group for action. The strategy acknowledges that stigma can be a barrier to people seeking support, and it encourages local government, the National Health Service, and voluntary sector organisations to work together to encourage the reduction of this stigma.

The Health and Care Act 2022 established integrated care systems, reforming how health and adult social care work together by putting partnership at the heart of planning. The Government has published guidance for integrated care partnerships (ICPs), on the statutory requirement for each ICP to publish an Integrated Care Strategy to address the health, social care, and public health needs of their system. All ICPs have now published their integrated care strategies.

The integration of health and social care is often best achieved through collaboration across smaller geographies within integrated care systems called places. Since the Health and Care Act 2022, we have seen good progress in the development of place-based arrangements to integrate health and social care. In October 2023, we published our Shared Outcomes Toolkit designed to help place-based partnerships develop shared outcomes as a powerful means of promoting integrated working and joined up care. We also issued a call for evidence as part of our review of Section 75 of the NHS Act 2006, which permits local authorities and National Health Service bodies to pool budgets, enabling joint commissioning and the commissioning of integrated services. The findings of this review will be shared in due course.

The National Health Service is a world leader in rolling out innovative treatments and has established a dedicated national programme team which is working in partnership with other national agencies and with local health systems to prepare for the potential roll out of new treatments for use in the earlier stages of Alzheimer’s disease. These plans assume that, if these new treatments are approved by the regulators, significant additional diagnostic capacity, including amyloid positron emission tomography–computed tomography, lumbar puncture and magnetic resonance imaging, will be needed both to identify patients who are most able to benefit and to provide important safety monitoring.

The national programme team is conducting preparations across the country, working alongside clinicians and local teams to identify where further funding will be required to roll out the additional tests and services needed to introduce these new and complex treatments.

NHS England is also working with partner agencies to support and inform further research into other diagnostic modalities, including blood-based biomarker and digital tests, which will help improve identification and management of Alzheimer’s disease.

The majority of palliative and end of life care is provided by core National Health Service staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services.

The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the integrated care board (ICB) footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide, and consequently, the funding arrangements reflect this.

However, since 2020, NHS England has provided hospices with over £350 million to secure and increase NHS capacity, and to support hospital discharge, as part of the COVID-19 response. In addition, since 2021/22, nearly £63 million has been provided to children’s hospices as part of the Children and Young People’s Hospice Grant. Furthermore, additional investment in children and young people’s palliative and end of life care, including hospices, has also been made through the NHS Long Term Plan’s commitment to match-fund clinical commissioning groups, and subsequently ICBs, totalling over £23 million.

As set out in the Health and Care Act 2022, ICBs are responsible for determining the level of NHS-funded palliative and end of life care locally, including hospice care, and are responsible for ensuring that the services they commission meet the needs of their local population.

As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an integrated care board (ICB) must commission, promoting a more consistent national approach, and supporting commissioners in prioritising palliative and end of life care.

The majority of palliative and end of life care is provided by National Health Service staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide, and consequently, the funding arrangements reflect this.

To support ICBs, NHS England has published statutory guidance and service specifications for both adults and children. NHS England has also commissioned the development of a palliative and end of life care dashboard, which brings together relevant, all age local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of both adults and children in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities.

NHS England has also funded seven strategic clinical networks for palliative and end of life care. These networks support commissioners in the delivery of outstanding clinical and personalised care for people in the last years of life, and reduce local variation.

At a national level, NHS England has confirmed it will renew the Children and Young People’s hospice funding for 2024/25, again allocating £25 million of grant funding for children’s hospices, using the same prevalence-based allocation approach as in 2022/23 and 2023/24. The Government has provided £60 million of additional funding to help deliver the one-off payments to over 27,000 eligible staff employed on dynamically linked Agenda for Change contracts by non-NHS organisations, including some hospices.

We remain hugely sympathetic to the families who believe that they have suffered as a result of using Hormone Pregnancy Tests. We have no plans to set up an independent review to examine the findings of the Expert Working Group. In the interests of transparency, all evidence collected and papers considered by the Expert Working Group were published in 2018, along with full minutes of its discussions. Details of conflicts of interests, and how these were managed, were also published.

Whilst no specific assessment has been made, we are already taking action to address the health issues that disproportionately impact men. This includes through policies announced on International Men’s Day, such as the appointment of a Men’s Health Ambassador, to raise the profile of men’s health issues. The Major Conditions Strategy will also focus on improving health outcomes linked to major condition areas like cancer, cardiovascular, and chronic respiratory diseases that disproportionately impact men.

The public health benefits of breastfeeding for child and maternal health are significant and well established. Research published in the British Medical Journal suggests that increasing breastfeeding rates, both in terms of duration and exclusivity, is likely to generate substantial cost savings to the National Health Service, although the actual amounts saved will depend on the extent of this increase.

Through the Family Hubs and Start for Life Programme, we are investing £50 million to increase the range of specialist support, which is enabling more parents to access face-to-face and virtual support whenever they need it. One of the objectives of the programme is to improve the evidence base around the impact of breastfeeding interventions, and the specific combination of interventions that are effective in different circumstances. This is expected to strengthen the case for further, more widespread investment in the future.

While the Government’s policy remains, that there are no plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate, there are extensive arrangements currently in place in England to ensure that prescriptions are affordable for everyone, including for those with asthma and chronic obstructive pulmonary disease.

Approximately 89% of prescription items are dispensed free of charge in the community in England, and there is a wide range of exemptions from prescription charges already in place for which those with heart disease may be eligible. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, or whether they are in receipt of certain benefits or a war pension.

People on a low income can apply for help with their health costs through the NHS Low Income Scheme. The scheme provides income related help to people who are not automatically exempt from charges, but who may be entitled to full or partial help if they have a low income and savings below a defined limit.

To support those with greatest need who do not qualify for an exemption or the NHS Low Income Scheme, Prescription Prepayment Certificates (PPCs) are available. PPCs allow people to claim as many prescriptions as they need for a set cost, with three month and 12 month certificates available, which can be paid for in instalments.

There are eight NHS inpatient detoxification units in England. They are listed below:

Guys and St Thomas NHS Trust (London),

Bridge House, Kent and Medway NHS Trust (Maidstone, Kent),

Dame Carol Black Unit, Midlands Foundation NHS Trust (Fareham, Hampshire),

Acer Unit, Avon & Wiltshire Mental Health Partnership NHS Trust (Bristol),

Edward Myers Unit, Staffordshire Combined NHS Trust (Stoke),

New Beginnings, Rotherham, Doncaster, South Humber Foundation NHS Trust (Doncaster), Chapman Barker Unit, Greater Manchester Mental Health NHS Trust (Manchester),

Topaz Ward, Essex Partnership NHS Trust (Chelmsford, Essex).

Naloxone is highly effective in reducing opioid overdose-related deaths, and the Government is working to widen access to, and increase the uptake of, this life saving drug. A prescription only medicine that is available across the United Kingdom, naloxone can be prescribed by a doctor or non-medical prescriber or provided, under a Patient Group Direction. It can also be supplied without prescription by drug services, which include specialist National Health Service and voluntary sector treatment services, as well as community pharmacies providing other substance misuse services across the UK.

Naloxone has been available for anyone to use in an emergency since 2005. There is good awareness of it, supported by earlier guidance by the Department and its agencies in 2015, 2018, 2019, and 2023. Drug treatment services and their suppliers also provide independent awareness-raising materials, targeting people who use opioids.

The Government launched a UK-wide public consultation to seek views on our proposal to amend the Human Medicines Regulations 2012 so that more professionals, services, and family members can give out take-home naloxone supplies. The consultation closed on 6 March 2024, and the responses are currently being analysed. The Government will publish its official response shortly.

The Government is working to increase naloxone carriage, and has provided additional investment in drug treatment services to support this work. In England, local authorities and their partners have been increasing naloxone supply in recent years. There are now three naloxone products available, and supply has been meeting demand. To enable the Government to respond to any future change in demand for naloxone, the Department is working with the Home Office to model scenarios where demand for naloxone may increase, and has conducted a commercial engagement exercise to better understand the naloxone market, and the market’s capacity to respond to changes in demand.

Naloxone is highly effective in reducing opioid overdose-related deaths, and the Government is working to widen access to, and increase the uptake of, this life saving drug. A prescription only medicine that is available across the United Kingdom, naloxone can be prescribed by a doctor or non-medical prescriber or provided, under a Patient Group Direction. It can also be supplied without prescription by drug services, which include specialist National Health Service and voluntary sector treatment services, as well as community pharmacies providing other substance misuse services across the UK.

Naloxone has been available for anyone to use in an emergency since 2005. There is good awareness of it, supported by earlier guidance by the Department and its agencies in 2015, 2018, 2019, and 2023. Drug treatment services and their suppliers also provide independent awareness-raising materials, targeting people who use opioids.

The Government launched a UK-wide public consultation to seek views on our proposal to amend the Human Medicines Regulations 2012 so that more professionals, services, and family members can give out take-home naloxone supplies. The consultation closed on 6 March 2024, and the responses are currently being analysed. The Government will publish its official response shortly.

The Government is working to increase naloxone carriage, and has provided additional investment in drug treatment services to support this work. In England, local authorities and their partners have been increasing naloxone supply in recent years. There are now three naloxone products available, and supply has been meeting demand. To enable the Government to respond to any future change in demand for naloxone, the Department is working with the Home Office to model scenarios where demand for naloxone may increase, and has conducted a commercial engagement exercise to better understand the naloxone market, and the market’s capacity to respond to changes in demand.

Naloxone is highly effective in reducing opioid overdose-related deaths, and the Government is working to widen access to, and increase the uptake of, this life saving drug. A prescription only medicine that is available across the United Kingdom, naloxone can be prescribed by a doctor or non-medical prescriber or provided, under a Patient Group Direction. It can also be supplied without prescription by drug services, which include specialist National Health Service and voluntary sector treatment services, as well as community pharmacies providing other substance misuse services across the UK.

Naloxone has been available for anyone to use in an emergency since 2005. There is good awareness of it, supported by earlier guidance by the Department and its agencies in 2015, 2018, 2019, and 2023. Drug treatment services and their suppliers also provide independent awareness-raising materials, targeting people who use opioids.

The Government launched a UK-wide public consultation to seek views on our proposal to amend the Human Medicines Regulations 2012 so that more professionals, services, and family members can give out take-home naloxone supplies. The consultation closed on 6 March 2024, and the responses are currently being analysed. The Government will publish its official response shortly.

The Government is working to increase naloxone carriage, and has provided additional investment in drug treatment services to support this work. In England, local authorities and their partners have been increasing naloxone supply in recent years. There are now three naloxone products available, and supply has been meeting demand. To enable the Government to respond to any future change in demand for naloxone, the Department is working with the Home Office to model scenarios where demand for naloxone may increase, and has conducted a commercial engagement exercise to better understand the naloxone market, and the market’s capacity to respond to changes in demand.

Naloxone is highly effective in reducing opioid overdose-related deaths, and the Government is working to widen access to, and increase the uptake of, this life saving drug. A prescription only medicine that is available across the United Kingdom, naloxone can be prescribed by a doctor or non-medical prescriber or provided, under a Patient Group Direction. It can also be supplied without prescription by drug services, which include specialist National Health Service and voluntary sector treatment services, as well as community pharmacies providing other substance misuse services across the UK.

Naloxone has been available for anyone to use in an emergency since 2005. There is good awareness of it, supported by earlier guidance by the Department and its agencies in 2015, 2018, 2019, and 2023. Drug treatment services and their suppliers also provide independent awareness-raising materials, targeting people who use opioids.

The Government launched a UK-wide public consultation to seek views on our proposal to amend the Human Medicines Regulations 2012 so that more professionals, services, and family members can give out take-home naloxone supplies. The consultation closed on 6 March 2024, and the responses are currently being analysed. The Government will publish its official response shortly.

The Government is working to increase naloxone carriage, and has provided additional investment in drug treatment services to support this work. In England, local authorities and their partners have been increasing naloxone supply in recent years. There are now three naloxone products available, and supply has been meeting demand. To enable the Government to respond to any future change in demand for naloxone, the Department is working with the Home Office to model scenarios where demand for naloxone may increase, and has conducted a commercial engagement exercise to better understand the naloxone market, and the market’s capacity to respond to changes in demand.

Smoking is responsible for approximately 80,000 deaths a year in the United Kingdom, and causes around one in four cancer deaths in the UK. It also costs our country £17 billion a year, and puts a huge burden on the National Health Service. Smoking is an addiction, and there is no liberty in addiction. It causes harm to not only the smoker, but to society as a whole. That is why we have introduced the Tobacco and Vapes Bill to create the first smokefree generation, and enable us to further crack down on youth vaping. The Tobacco and Vapes Bill is available at the following link:

https://bills.parliament.uk/bills/3703

The UK is a party to the World Health Organization Framework Convention on Tobacco Control, and under Article 5.3 has an obligation to protect the development of public health policy from the vested interests of the tobacco industry. As a world leader in tobacco control, the Government takes this commitment very seriously. In 2023, the Department published guidance for Government engagement with the tobacco industry, which is available at the following link:

https://www.gov.uk/government/publications/protocol-for-engagement-with-stakeholders-with-links-to-the-tobacco-industry/guidance-for-government-engagement-with-the-tobacco-industry

The Department regularly publishes correspondence from, or to, those with links to the tobacco industry, and it is available at the following link:

https://khub.net/web/phe-national/public-library/-/document_library/v2WsRK3ZlEig/view/394794557