Department of Health and Social Care

In recent years, the cohort of national clinical directors has expanded and is now supported by an additional cadre of national specialty advisors.

Ministers and senior Department officials are working with the new executive team in NHS England, led by Sir Jim Mackey, to determine the leadership, structure, and requirements needed to support the creation of a new centre for health and care. As part of this process, we are carefully considering the future role of national clinical directors. While no specific decisions have been made yet regarding their scope and responsibilities within the new organisation, their expertise and leadership will continue to be pivotal in shaping the future of healthcare in our country.

NHS England keeps the selection process for foundation training under review to make sure it works well for applicants.

Internationally educated staff remain an important part of the workforce, and our Code of Practice for International Recruitment ensures stringent ethical standards when recruiting health and social care staff from overseas. However, the Government is also committed to growing homegrown talent and giving opportunities to more people across the country to join our National Health Service.

The National Health Service’s national cost collection gives a national average unit cost of £751 across all planned procedures within outpatients, day cases, and elective inpatient settings in 2023/24. This is the equivalent to 1,331 procedures per £1 million. Further information on the NHS’s national cost collection is available at the following link:

https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/

Prices for individual procedures are set out in the NHS Payment Scheme. How the procedures are delivered is a local decision, to reflect local population need and to allow for the greatest opportunity to deliver value for money in local budgets. The Department does not hold a national estimate by procedure of care delivered through insourcing or outsourcing. However, NHS guidance for both insourcing and outsourcing makes clear the expectation that services are contracted at or below the unit prices set out in the NHS Payment Scheme.

Individual National Health Service trusts and foundation trusts are responsible and accountable for their own purchasing decisions, which will include community equipment. NHS organisations are independent commercial entities, and it is for an NHS procuring authority to satisfy itself on how best to obtain quality and value for money through its procurement activity.

Local NHS organisations have access to a wide range of procurement routes, but the Government has put in place a range of initiatives to help NHS bodies make informed choices about products and the route through which they are bought. These include the NHS Supply Chain, a national body which is responsible for procuring and delivering the majority of consumables, equipment, and other supplies to the NHS. The NHS Supply Chain was set up to leverage the collective buying power of the NHS to drive savings and provide a standardised range of clinically assured quality products at the best value.

NHS England is responsible for funding allocations to integrated care boards (ICBs). This process is independent of the Government, and NHS England takes advice on the underlying formulae from the independent Advisory Committee on Resource Allocation. ICB allocations for 2025/26 were published on 30 January 2025, and include a breakdown of per capita funding for each ICB, with further information available at the following link:

https://www.england.nhs.uk/allocations/

There are no plans for any of the new hubs to focus solely on orthopaedic procedures, but five of the new surgical hubs will focus on orthopaedics procedures in addition to other specialties.

The Elective Reform Plan committed to providing quicker access for patients to common surgical procedures by opening 14 new and three expanded surgical hubs by June 2025, and ramping up the number of hubs over the next three years, so more operations can be carried out. They focus on driving improvements in six high volume specialties: ophthalmology; general surgery; trauma and orthopaedics, which includes spinal surgery; gynaecology; ear, nose and throat; and urology.

We have committed to develop a 10-Year Health Plan to deliver a National Health Service fit for the future. As part of these reforms, we are determined to shift more healthcare out of hospitals and into the community, to ensure patients and families receive the care they need when and where they need it.

The use of evidence is embedded in our development of the 10-Year Health Plan, both by informing the proposals developed by the working groups supporting the plan, and in our ongoing assessment of the plan’s potential impacts. Both areas of work draw on a broad range of evidence, including published sources outside of the Department and NHS England.

Decisions about the employment of newly qualified physiotherapists are a matter for individual National Health Service trusts. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.

We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.

The Department works closely with the Department for Education on a wide range of matters to ensure the education system is supporting healthcare students, including student funding.

For the 2025-26 academic year, the Government will increase the NHS Bursary tuition fee contributions, maintenance grants and all allowances by 3.1%. This is the second consecutive academic year that this Government has increased support through the NHS Bursary. For the 2025-26 academic year, the Government has also announced that maximum loans for living costs from Student Finance England (SFE), including reduced rate non-means tested loans for students in NHS Bursary years, will increase by 3.1%.

The Government reviews the funding arrangements for medical students annually. This includes the NHS Bursary scheme and SFE support.

The Department works closely with the Department for Education on a wide range of matters to ensure the education system is supporting healthcare students, including student funding.

For the 2025-26 academic year, the Government will increase the NHS Bursary tuition fee contributions, maintenance grants and all allowances by 3.1%. This is the second consecutive academic year that this Government has increased support through the NHS Bursary. For the 2025-26 academic year, the Government has also announced that maximum loans for living costs from Student Finance England (SFE), including reduced rate non-means tested loans for students in NHS Bursary years, will increase by 3.1%.

The Government reviews the funding arrangements for medical students annually. This includes the NHS Bursary scheme and SFE support.

The Department works closely with the Department for Education on a wide range of matters to ensure the education system is supporting healthcare students, including student funding.

For the 2025-26 academic year, the Government will increase the NHS Bursary tuition fee contributions, maintenance grants and all allowances by 3.1%. This is the second consecutive academic year that this Government has increased support through the NHS Bursary. For the 2025-26 academic year, the Government has also announced that maximum loans for living costs from Student Finance England (SFE), including reduced rate non-means tested loans for students in NHS Bursary years, will increase by 3.1%.

The Government reviews the funding arrangements for medical students annually. This includes the NHS Bursary scheme and SFE support.

The Department does not hold the information requested. Data is not held on the number of prescriptions dispensed in the community in England free of charge to asylum seekers.

There is no automatic exemption from prescription charges for asylum seekers, however individuals may be entitled to exemption from charges for other reasons such as age or through application to the NHS Low Income Scheme (LIS). If an individual who is an asylum seeker has a prescription that includes a charge exemption, it would be recorded in the system in the same way as any other prescription with that exemption.

Asylum seekers who are supported by UK Visas and Immigration (UKVI), Section 95 support, who may be housed by UKVI or in accommodation prior to dispersal, are sent a HC2 certificate, valid for six months, for full help. Other asylum seekers may make an NHS LIS claim using the HC1 certificate form.

The Department does not hold the information requested. Data is not held on the number of prescriptions dispensed in the community in England free of charge to asylum seekers.

There is no automatic exemption from prescription charges for asylum seekers, however individuals may be entitled to exemption from charges for other reasons such as age or through application to the NHS Low Income Scheme (LIS). If an individual who is an asylum seeker has a prescription that includes a charge exemption, it would be recorded in the system in the same way as any other prescription with that exemption.

Asylum seekers who are supported by UK Visas and Immigration (UKVI), Section 95 support, who may be housed by UKVI or in accommodation prior to dispersal, are sent a HC2 certificate, valid for six months, for full help. Other asylum seekers may make an NHS LIS claim using the HC1 certificate form.

The Government is committed to putting patients first, including those waiting for joint replacement surgery.

We understand the impact long waits can have on patients’ mental health, and we are committed to ensuring that people can access high quality mental health support when they need it. As part of this, we will recruit 8,500 mental health workers to ease pressure on busy mental health services. Separately, in the Government’s Plan for Change we have committed to return to the 18-week Referral to Treatment standard, which has not been met for almost a decade.

We will ensure that patients are not only seen on time but also have the best possible experience of care. Our Elective Reform Plan, published on 6 January 2025, has committed us to working with patients and their carers to co-develop minimum standards for their experience of care.

Dedicated and protected surgical hubs are helping to reduce elective surgery wait times by focusing on high volume low complexity surgeries, such as joint replacement surgery. As of March 2025, there are 114 elective surgical hubs that are operational across England.

The Elective Reform Plan has committed to providing quicker access for patients to common surgical hub procedures by opening 17 new and expanded surgical hubs by June 2025 and ramping up the number of hubs over the next three years, so even more operations can be carried out near where patients live.

The Government is committed to putting patients first, including those waiting for joint replacement surgery.

We understand the impact long waits can have on patients’ mental health, and we are committed to ensuring that people can access high quality mental health support when they need it. As part of this, we will recruit 8,500 mental health workers to ease pressure on busy mental health services. Separately, in the Government’s Plan for Change we have committed to return to the 18-week Referral to Treatment standard, which has not been met for almost a decade.

We will ensure that patients are not only seen on time but also have the best possible experience of care. Our Elective Reform Plan, published on 6 January 2025, has committed us to working with patients and their carers to co-develop minimum standards for their experience of care.

Dedicated and protected surgical hubs are helping to reduce elective surgery wait times by focusing on high volume low complexity surgeries, such as joint replacement surgery. As of March 2025, there are 114 elective surgical hubs that are operational across England.

The Elective Reform Plan has committed to providing quicker access for patients to common surgical hub procedures by opening 17 new and expanded surgical hubs by June 2025 and ramping up the number of hubs over the next three years, so even more operations can be carried out near where patients live.

There are currently no plans to publish an implementation plan alongside the Elective Reform Plan.

Our Elective Reform Plan sets out the productivity and reform efforts needed to return to the 18-week constitutional standard by the end of this Parliament, and outlines how these will be implemented by National Health Service systems, including a series of milestones for delivery. We have hit our pledge to deliver two million extra elective appointments early, and have now exceeded that pledge by delivering over three million more appointments.

In addition, the Planning Guidance for 2025/26 has since been published and confirmed the interim targets for 2025/26, including a target that 65% of patients wait for 18 weeks or less by March 2026, up from 58.9% in January 2025, with every trust expected to deliver a minimum 5% improvement on current performance over that period.

The National Institute for Health and Care Excellence (NICE) is the independent body that develops recommendations for the National Health Service on whether new licensed medicines should be routinely funded by the NHS based on an assessment of clinical and cost effectiveness. The NICE evaluates all new licensed cancer medicines and aims wherever possible to issue recommendations close to the time of licensing. The NHS in England is legally required to fund treatments recommended by the NICE. The NICE published guidance that recommends the tyrosine kinase inhibitors crizotinib and entrectinib for use in the treatment of people with ROS1 positive advanced non-small cell lung cancer who have not previously been treated with ROS1 inhibitors. These treatments are now routinely funded by the NHS for eligible patients.

The Department has had no discussions with the NICE or pharmaceutical companies on encouraging clinical trial funding in this area. The Department is working closely with the NHS, industry, academia, research regulators, and charities to make clinical research in the United Kingdom more efficient, more competitive, and more accessible. We expect these efforts to attract more commercial investment in clinical research and yield a broad and diverse portfolio of clinical trials in the UK, including clinical trials for cancer. The Department funded National Institute for Health and Care Research (NIHR) funds research and research infrastructure, which supports patients and the public to participate in high-quality research, including clinical research on cancer. NIHR research expenditure for all cancers was £133 million in 2023/24, reflecting its high priority. These investments are pivotal towards efforts to improve cancer prevention, treatment, and outcomes.

The Government recognises that delivering high quality National Health Service healthcare requires the right infrastructure in the right places.

Integrated care systems (ICSs) are responsible for strategic infrastructure planning as well as managing the operational capital for their respective local areas. This includes expanding and developing hospital facilities. The Department is supporting local NHS organisations to better manage their estates, and systems have developed infrastructure strategies which will inform their decision making and estate management.

In this context, the Stockport Metropolitan Borough Council and other local authorities are encouraged to engage with their local integrated care board (ICB), the Greater Manchester ICB, to discuss opportunities for developing hospital infrastructure.

Detailed plans are being formulated by a joint Department and NHS England programme team. The remit of work includes formulation of the relevant costs and securing the required funding. Funding conversations between the Department of Health and Social Care, NHS England, and HM Treasury are ongoing. Further detail on the costs and funding mechanisms will be provided as this work develops.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not made a formal assessment of the impact of differences in regulations on wax removal between registered nurses and non-registered practioners on patient care. The Department does not have plans to intervene in locally led arrangements for the provision of ear wax removal services. Integrated care boards are responsible for commissioning ear wax removal services in local areas in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence.

New artificial intelligence (AI) technologies are being developed that have the potential to improve healthcare delivery and to provide significant cost savings to the National Health Service. One example is the use of automated voice to text tools, which use generative AI to listen to and transcribe patient notes.

Currently, there are ongoing assessments of the use of these tools in the NHS as these technologies could help ease the administrative burden faced by staff and make systems more efficient. Several NHS trusts are running trials, including a multi-site assessment of the impact of using automated transcription software. The NHS AI team is monitoring these developments and developing guidance for the responsible use of these tools. This guidance will be informed by the Government’s broader guidance on the use of Generative AI in the public sector.

There are strict safeguards in place throughout the NHS to protect data. All providers of services which handle patient data must protect that data in line with the UK General Data Protection Regulation (GDPR), and Data Protection Act 2018, and every health organisation is required to appoint a Caldicott Guardian to advise on the protection of people’s health and care data, and ensure it is used properly. This includes where AI is used in relation to patient records.

To mitigate the likelihood and severity of any potential harm to individuals arising from use of data in AI, the Information Commissioner’s Office (ICO) has developed detailed AI guidance which provides an overarching view of data protection, including Data Protection Impact Assessments and UK GDPR. It has also produced an AI toolkit to support organisations auditing compliance of their AI-based technologies. NHS bodies are expected to make use of this guidance and toolkit.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it.

We will ensure that the number of medical specialty training places meets the demands of the National Health Service in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.

To reform the NHS and make it fit for the future, we have launched a 10-Year Health Plan as part of the Government’s five long-term missions. Ensuring we have the right people, in the right places, with the right skills will be central to this vision.  We will publish a refreshed Long Term Workforce Plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.

We are aware of both the Annual Review and Triennial Review from the Local Government and Social Care Ombudsman (LGSCO) and support the work they do to ensure that those receiving care, whether self-funded or placed by their local authority, are aware of the options available to them if they wish to escalate their complaint. We are working across the Government on a response to the LGSCO’s recommendations, including on increasing awareness of the role of the LGSCO for those privately funding their care.

We are aware of both the Annual Review and Triennial Review from the Local Government and Social Care Ombudsman (LGSCO) and support the work they do to ensure that those receiving care, whether self-funded or placed by their local authority, are aware of the options available to them if they wish to escalate their complaint. We are working across the Government on a response to the LGSCO’s recommendations, including on increasing awareness of the role of the LGSCO for those privately funding their care.

We are aware of both the Annual Review and Triennial Review from the Local Government and Social Care Ombudsman (LGSCO) and support the work they do to ensure that those receiving care, whether self-funded or placed by their local authority, are aware of the options available to them if they wish to escalate their complaint. We are working across the Government on a response to the LGSCO’s recommendations, including on increasing awareness of the role of the LGSCO for those privately funding their care.

The Department does not directly fund air ambulance services on a routine basis. Air ambulances in England operate as independent charities and are supported by the National Health Service through the provision and training of key clinical staff.

The Department has made no such estimate. The Department publishes income identified and cash recovered from overseas visitors, which includes expatriates, visitors and undocumented migrants, on an annual basis in its annual report and accounts. The latest report and accounts are available at the following link:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2023-to-2024

Single-sex spaces are protected in law and will always be protected by the Government. This is the law, and we expect all public service bodies to comply. The recent Supreme Court ruling in the For Women Scotland case has provided much needed confidence and clarity for the National Health Service to adapt its policies to ensure that same-sex spaces are always protected. This includes NHS England’s review of the Delivering same-sex accommodation guidance, as well as providers’ policies on same-sex spaces for staff.

The Department does not hold data on how many or what proportion of maternity services were accessed by foreign nationals in each of the last five years.

NHS England has asked the integrated care boards (ICBs) to act as main strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure to achieve a 50% cost reduction in their running cost allowance. NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, and tasked ICBs with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. Further information is available at the following link:

https://www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/

In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time. The Cambridgeshire and Peterborough ICB is within range of their fair shares allocation targets.

The Department is unable to confirm a timetable at this stage. Amendments to the Human Medicines Regulations 2012 and Misuse of Drug Regulations 2001 would be required to enable electronic prescribing in named settings, such as secondary care and the health and justice system. Changes to this legislation would require public consultation and agreement with Parliament under the affirmative procedure.

Individual National Health Service trusts and foundation trusts are responsible and accountable for their own purchasing decisions, which will include medical equipment. NHS organisations are independent commercial entities, and it is for an NHS procuring authority to satisfy itself on how best to obtain quality and value for money through its procurement activity.

Local NHS organisations have access to a wide range of procurement routes, but the Government has put in place a range of initiatives to help NHS bodies make informed choices about the products and the route through which they are bought. These include NHS Supply Chain, a national body which is responsible for procuring and delivering most consumables, medical equipment and other supplies into the NHS. NHS Supply Chain was set up to leverage the collective buying power of the NHS to drive savings and provide a standardised range of clinically assured quality products at the best value.

NHS Professionals Ltd (NHSP), a limited company wholly owned by the Department, is a supplier of clinical and non-clinical temporary workforce to client National Health Service trusts.

The following table shows NHSP profit before tax and dividends paid to the Department over the last five years:

Dividends received from NHSP are not ringfenced for specific purposes, but they are directly invested back into the wider healthcare economy by the Department. Where dividends are not taken, any profits generated are retained within the business and reinvested to support the delivery of its strategy.

Full details of profits, dividend payments and declarations are shown in NHSP’s statutory accounts which are available at the following link:

https://find-and-update.company-information.service.gov.uk/company/06704614

Two medical directors have been confirmed in the NHS England transformation executive team. One for secondary care, the other for primary care.

Ministers and senior Department officials are working with the new executive team in NHS England, led by Sir Jim Mackey, to determine the leadership, structure, and requirements needed to support the creation of a new centre for health and care.

We are ensuring that people have the best possible experience during their care, including in the Ashfield constituency. We have already exceeded our pledge to deliver an extra two million operations, scans, and appointments, with three million more delivered between July 2024 and January 2025.

In Ashfield, Nottinghamshire Integrated Care Board has been working with local National Health Service trusts and independent sector providers to secure additional capacity to see, diagnose and treat patients; review all waiting times; reduce any inequity of waits; and support patient choice.

We have also increased diagnostic capacity in Ashfield through investment in new computed tomography and magnetic resonance imaging scanners and reducing wasted appointments through improved communication with patients. This has resulted in waits for diagnostic tests improving significantly, contributing to improvements in the overall waits for diagnosis and treatment. It has also led to a reduction in the number of patients waiting more than 52 weeks for surgery and improvements in the number of patients who are seen and treated within 18 weeks.

As set out in the Plan for Implementation, the New Hospital Programme (NHP) review used a range of data to assess and scope schemes, including the North Devon District Hospital scheme. This included assessing each scheme under criteria for mitigated risk, including health deprivation, deliverability, and transformation opportunity. As a result, North Devon is now in Wave 3 of the NHP and is expected to begin construction between 2035 and 2038. Further information on the Plan for Implementation is available at the following link:

https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-plan-for-implementation

Additionally, an equality impact assessment was carried out for the review into the NHP, which included assessing the extent to which service users might be impacted by these delivery proposals, with specific reference to the impact that these might have on relevant protected characteristics. This was laid in the House Library and published on 20 January, and is available at the following link:

https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-equality-impact-assessment

I along with my hon. Friend, the Minister of State for Care, both met with the Review Body on Doctors' and Dentists' Remuneration at the scheduled oral evidence sessions in February 2025, one focussing on secondary care doctors, and the other on general practitioners and dentists.

Oral evidence sessions are a regular feature of the annual pay review process and enable the pay review body to ask questions directly of ministers or to clarify points from the Department’s written evidence. Officials accompany ministers to these meetings. All parties to the pay review process, including the British Medical Association, are invited to give oral evidence.

The Government is committed to delivering a National Health Service that is fit for the future. This means we need to see world class NHS infrastructure across the entire NHS estate. Beyond hospitals, we know we need the right infrastructure in the right place to deliver a true Neighbourhood Health Service and to ensure that patients receive the care they deserve.

The Department of Health and Social Care is working closely with the Ministry of Housing, Communities, and Local Government on how to extend our collective interactions in the planning process, from local plan making to negotiating developer contributions, through updates to national guidance. This is alongside our support for the Ministry of Housing, Communities, and Local Government’s efforts to streamline the planning process, by extensively feeding into the ways in which health infrastructure plans can facilitate this.

At this stage, while we are scoping the transformation programme, it is too early to share details of any redundancy programmes and what any terms will be regarding the clawback of redundancy payments.

The leadership of the Department and NHS England will communicate information about these reforms to staff at the earliest opportunity, and are committed to a culture of transparency.

The Government recognises that delivering high-quality National Health Service healthcare requires safe and effective infrastructure.

Integrated care systems (ICSs) are responsible for strategic infrastructure planning for their respective areas and were recently commissioned by NHS England to develop 10-year infrastructure strategies. As part of these strategies, systems assessed how the estate, digital, equipment, and workforce models contribute to the delivery of the overarching system strategy, related clinical pathways, and national priorities for delivering care. The strategies included consideration of the condition of the estate.

In 2025/26, the Greater Manchester Integrated Care Board (ICB), responsible for Stepping Hill Hospital, has been provisionally allocated £187 million for operational capital, over £36 million for estates safety, and over £30 million to support constitutional standards recovery. The Stockport NHS Foundation Trust is encouraged to discuss options with the Greater Manchester ICB to allocate some of their operational capital and national programme allocations towards tackling the backlog of maintenance and ensuring that infrastructure supports quality care at Stepping Hill Hospital.

We are pleased that despite challenging infrastructure, the Stockport NHS Foundation Trust has made progress towards reducing its waiting list. As of February 2025, there were 35,824 patient pathways waiting for a procedure. Of these, 54.3% of pathways were waiting within 18 weeks for a procedure. This compares to 50.3% of pathways waiting within 18 weeks for a procedure in February 2024.

The Government supports efforts to utilise National Health Service capacity out of hours and over weekends, where it is a cost-effective and sustainable means of delivering additional activity. The most cost-effective route to do this is best determined at a local level, where integrated care boards and trusts can evaluate the options available to them.

We recognise insourcing as an opportunity to maximise productivity and efficiency and published guidance in 2024 to promote the effective utilisation of their services, available at the following link:

https://www.england.nhs.uk/long-read/guidance-for-trusts-on-the-use-of-insourcing/

The guidance is clear that, to promote value for money being achieved, arrangements should be at or below the unit prices set out in the NHS payment scheme. The guidance also asks all trusts to ensure that appropriate due diligence is undertaken before utilising insourcing solutions, including ensuring pay rates are at or below NHS England’s agency price caps.

This guidance sits alongside the Insourcing of Clinical Services Framework Agreement, published by NHS Shared Business Services, which supports local NHS organisations with the timely procurement of services, and which is available at the following link:

https://www.sbs.nhs.uk/services/framework-agreements/insourcing-of-clinical-services/

We have set clear elective priorities for the system in the Elective Reform Plan and 2025/26 Planning Guidance, including that every trust will need to deliver a minimum 5% improvement by March 2026. We expect trusts to be using all levers to deliver this.

The Government supports efforts to utilise National Health Service capacity out of hours and over weekends, where it is a cost-effective and sustainable means of delivering additional activity. The most cost-effective route to do this is best determined at a local level, where integrated care boards and trusts can evaluate the options available to them.

We recognise insourcing as an opportunity to maximise productivity and efficiency and published guidance in 2024 to promote the effective utilisation of their services, available at the following link:

https://www.england.nhs.uk/long-read/guidance-for-trusts-on-the-use-of-insourcing/

The guidance is clear that, to promote value for money being achieved, arrangements should be at or below the unit prices set out in the NHS payment scheme. The guidance also asks all trusts to ensure that appropriate due diligence is undertaken before utilising insourcing solutions, including ensuring pay rates are at or below NHS England’s agency price caps.

This guidance sits alongside the Insourcing of Clinical Services Framework Agreement, published by NHS Shared Business Services, which supports local NHS organisations with the timely procurement of services, and which is available at the following link:

https://www.sbs.nhs.uk/services/framework-agreements/insourcing-of-clinical-services/

We have set clear elective priorities for the system in the Elective Reform Plan and 2025/26 Planning Guidance, including that every trust will need to deliver a minimum 5% improvement by March 2026. We expect trusts to be using all levers to deliver this.

The Stockport Foundation NHS Trust submitted an expression of interest (EOI) to join the New Hospital Programme (NHP) in 2021, alongside other National Health Service trusts. The Department worked with NHS England on a joint prioritisation exercise assessing the EOIs in detail.

All EOIs were scored against a series of indicators from four categories: deliverability; better and smarter use of NHS infrastructure; fairer allocation of investment and efficient use of public resources; and stronger and greener NHS buildings. This assessment was conducted in conjunction with an analysis of metrics covering estates, finance, and quality from existing national datasets. An assessment of these EOIs against regional strategic priorities was also conducted.

In May 2023, the Government confirmed that five hospitals constructed primarily using reinforced autoclaved aerated concrete (RAAC) would be brought into the NHP, following a structural assessment by NHS England and the Department, which found that these hospitals would be unsafe to operate beyond 2030. Due to the size, complexity, and costs involved in rebuilding RAAC hospitals, it was not possible to invite other schemes to join.

We are supporting the Stockport Foundation NHS Trust to improve the condition of the infrastructure at Stepping Hill Hospital, with up to £11.5 million from the critical infrastructure risk fund confirmed in 2024/25 to support the replacement of outpatient capacity and to deliver much needed improvements to patient and staff safety.

There are no current plans to have discussions with my Rt Hon. Friend, Secretary of State for Work and Pensions on the research specified, or for the Department for Health and Social Care to assess the use of chiropractors to reduce waiting times in Newcastle-under-Lyme. Cutting waiting lists forms a key part of the Government’s mission to reform the National Health Service.