Department of Health and Social Care

This specific assessment has not been made. Contractual redundancy provisions for staff covered by the NHS Terms and Conditions of Service handbook, also referred to as Agenda for Change, in England were agreed and ratified in partnership by the NHS Staff Council, the collective bargaining structure made up of trade union and employer representatives. Any future changes to the handbook, including this section, would require the Department to issue a mandate to allow negotiations to be undertaken by the NHS Staff Council.

Mental health and psychosocial support, such as renal psychology services, for people living with kidney disease is a key priority within NHS England’s programme to improve renal care. The Renal Service Transformation Programme, published in 2023, provides a national framework for raising standards across the renal pathway, including a strengthened focus on supporting the emotional and psychological needs of patients.

There are no plans by either the Department or NHS England to review the list of health and care professions that are represented by the Chief Allied Health Professions officer.

Where there is demand for services, such as those provided by a chiropractor, integrated care boards are able to make independent decisions on which health professionals they employ and may commission a limited amount of such treatment.

The Government’s Chief Medical Officer, Professor Chris Whitty, and the former National Medical Director at NHS England, Professor Stephen Powis, have led the Medical Training Review to understand current challenges and identify key areas for potential improvements in postgraduate medical education, which includes the UK Foundation Programme. Phase one of the review was published in October 2025.

No assessment has been made. The Government is fully committed to attracting, training, and recruiting the mental health workforce of the future, including clinical psychologists.

We will publish a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed services set out in the 10-Year Health Plan.

Section 16 of the NHS Terms and Conditions of Service handbook, also referred to as Agenda for Change, was last updated in 2015. This section sets out the contractual redundancy provisions for staff covered by these terms and conditions and took effect in England from 1 April 2015.

We have no current plans to update this section. These provisions were agreed and ratified in partnership by the NHS Staff Council, the collective bargaining structure made up of trade union and employer representatives. Any future changes to the handbook, including this section, would require the Department to issue a mandate to allow negotiations to be undertaken by the NHS Staff Council.

We have interpreted this question as asking when the Department plans to publish revised Health Building Notes (HBNs). HBNs are developed and published by the NHS England Estates division and are available at the following link:

https://www.england.nhs.uk/estates/health-building-notes/

Planned updates to these HBNs are based on their prioritisation related to identified changes in policy, regulation, technology, and clinical practice, as well as available resources. We are systematically updating these and working closely with specialists in the devolved administrations to progress updates to the HBNs and other guidance.

The Government does not plan to introduce transitional arrangements ahead of the Medical Training (Prioritisation) Bill coming into force.

It is the intention of the Department to commence the bill as soon as we are able, subject to passage through Parliament.

As set out in the Plan for Change, we have committed to return to the National Health Service constitutional standard that 92% of patients, including those waiting for musculoskeletal treatment, wait no longer than 18 weeks from referral to treatment by March 2029.

The Elective Reform Plan, published in January 2025, set out the productivity and reform efforts we will undertake to return to the 18-week standard, and to ensure patients have the best possible experience while they wait.

NHS England does not nationally commission chiropractic care as it is a complementary and alternative medicine. Integrated care boards can make independent decisions on which health professionals they employ and may commission a limited amount of such treatment.

There are currently no plans to review the categorisation of chiropractic care as a complementary and alternative medicine. Where musculoskeletal treatment is required, referrals will be made to physiotherapists where appropriate.

At the Autumn Budget, we announced our commitment to deliver 250 Neighbourhood Health Centres (NHCs) through the NHS Neighbourhood Rebuild Programme. This will deliver NHCs through a mixture of upgrades to expand and improve sites over the next three years, and new build sites opening in the medium term.

The first 120 NHCs are due to be operational by 2030 and will be delivered through a mixture of public private partnerships and public capital. 50 of these will be delivered through upgrades and 70 will be new builds.

The 2025 Spending Review settlement provides £426 million over four years for improvements in the primary care estate. Up to half of this funding will support upgrades to existing buildings to deliver NHCs this Parliament. Further information on NHCs and funding will be published over the coming months

At a local level, National Health Service trusts and integrated care boards are responsible for delivery, implementation, and funding decisions for services, including managing the local capital budget for their areas, and allocating funds according to local priorities, such as investment in healthcare facilities.

National bodies such as the National Institute for Health and Care Excellence and the Royal College of Midwives have issued guidelines emphasising the importance of involving fathers and partners in maternity and perinatal care. These guidelines set expectations for trusts to adopt family-centred care and to treat fathers as active participants, not just visitors or observers. These resources are available, respectively, at the following two links:

https://www.nice.org.uk/guidance/ng201/chapter/recommendations#:~:text=Antenatal%20classes-,1.3.,NICE%20guideline%20on%20postnatal%20care

https://rcm.org.uk/wp-content/uploads/2024/06/engaging_dads_pocket_guide.pdf

The Department and NHS England do not hold data on the proportion of births in National Health Service facilities at which a father is present.

National bodies such as the National Institute for Health and Care Excellence and the Royal College of Midwives have issued guidelines emphasising the importance of involving fathers and partners in maternity and perinatal care. These guidelines set expectations for trusts to adopt family-centred care and to treat fathers as active participants, not just visitors or observers. These resources are available, respectively, at the following two links:

https://www.nice.org.uk/guidance/ng201/chapter/recommendations#:~:text=Antenatal%20classes-,1.3.,NICE%20guideline%20on%20postnatal%20care

https://rcm.org.uk/wp-content/uploads/2024/06/engaging_dads_pocket_guide.pdf

The Department and NHS England do not hold data on the proportion of births in National Health Service facilities at which a father is present.

Many National Health Service trusts and Accredited Education Providers such as universities have developed their own training programmes or academic modules around Trauma Informed Care (TIC) for midwives. NHS England is undertaking a rapid scoping exercise on current TIC mandatory and non-mandatory training provision across perinatal services, to assess the merit of more comprehensive TIC training for staff.

The Tower Hamlets Muslim Charity Run is not funded by NHS Barts Health Trust. National Health Services are available to all, irrespective of sex. The Government does not tolerate discrimination within public services.

Analysis shows that the anticipated workforce available to provide women’s health services through the NHS online hospital, provides enough capacity to meet the demand for the service in the first three years.

The following table shows the total legal fees for the core Department per the audited annual reports from 2020/21 to 2024/25, rounded to the nearest thousand:

The legal fees for the departmental group can be found in the Annual Report and accounts in the following links:

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2024-to-2025#

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

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2022-to-2023

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2021-to-2022

https://www.gov.uk/government/publications/dhsc-annual-report-and-accounts-2020-to-2021

The results from NHS England’s Maternity and Neonatal Infrastructure Review, commissioned in 2023, showed that there are 747 parental accommodation rooms within neonatal units nationally. NHS England does not hold data on the standard of these rooms. However, there is undoubtedly variation in the provision of parental accommodation at neonatal units across England and we know that not all maternity hospitals are currently able to offer adequate accommodation for families due to the historic undercapitalisation across the National Health Service. A summary of the findings report is available at the following link:

https://www.england.nhs.uk/long-read/maternity-and-neonatal-infrastructure-review-findings/#:~:text=Against%20a%20backdrop%20of%20a,serious%20risk%20of%20imminent%20breakdown.

Data on the number of parental accommodation rooms is attached.

Mission boards have been reformed to become delivery-focused forums benefitting from external and industry expertise, led by the relevant Secretary of State.

The 10-Year Health Plan, published in July 2025, is delivering our Health Mission. Ministers and external stakeholders are involved in a variety of forums to take forward the various elements of the 10-Year Health Plan.

Maternity services are required to provide care in line with National Institute for Health and Care Excellence guidelines on antenatal care and pregnancy, reference code NG201, and complex social factors, reference code CG110. These guidelines specify that women should be asked about substance use, including cannabis use, as part of routine antenatal care.

Women requiring support for substance misuse should be offered a personalised care and support plan which may include referrals to specialist services. NHS England recently published the Improving postnatal care toolkit which aims to support system leaders improve postnatal care. This includes the development of targeted care pathways for vulnerable groups, such as women affected by substance misuse.

Pelvic physiotherapy is an established and expanding component of National Health Service pelvic health services, delivered across maternity, gynaecology, community services, and specialist pathways. Across wider gynaecology and women’s health hubs, pelvic health physiotherapy is routinely offered for pelvic pain, pelvic floor dysfunction, urinary/faecal incontinence, prolapse, dyspareunia, and other presentations commonly associated with endometriosis. Multidisciplinary pelvic pain management, including pelvic physiotherapy, is an expected component within women’s health hubs.

The Government is encouraging integrated care boards to further expand the coverage of women’s health hubs and supporting them to use the learning from the women’s health hub pilots to improve local delivery of services to women and girls. This should enable improved access to pelvic physiotherapy and earlier intervention for conditions such as endometriosis.

The Department has not made an assessment of the adequacy of the number of specialist doctors and nurses for headaches employed in the National Health Service in England.

Patients presenting with headaches may be treated through multiple points of contact across primary, urgent, and secondary care, with input from different clinical teams depending on symptoms and severity.

I refer the Hon. Member to the answer I gave to the Hon. Member for North Devon on 28 November 2025 to Question 92661.

The Government acknowledges the challenges faced by women with endometriosis and the impact it has on their lives, their relationships, and their participation in education and the workforce. We are committed to improving the diagnosis, treatment, and ongoing care for gynaecological conditions including endometriosis.

The 10-Year Health Plan set out our ambition for high autonomy to be the norm across every part of the country. Integrated care boards (ICBs) are responsible for commissioning services that meet the healthcare needs of their local population and have the freedom to do so, and this includes women's health hubs and delivering the direction of the Women's Health Strategy. The Government is backing ICBs to do this through record funding. The 2025 Spending Review prioritised health, with record investment in the health and social care system.

There are currently no plans to expand the Graduate Guarantee to physiotherapy graduates.

We know from engagement on the 10-Year Health Plan that many National Health Service staff feel disempowered and overwhelmed. Tackling this and providing proper support for staff is a top priority. NHS organisations have a responsibility to create supportive working environments for staff, ensuring they have the conditions they need to thrive, including access to high quality health and wellbeing support.

The Government is committed to publishing a 10 Year Workforce Plan which will have a focus on supporting and retaining our hardworking and dedicated healthcare professionals. This includes the development of a new set of staff standards for modern employment, which will reaffirm our commitment to improving retention and are likely to focus on flexible working, improving staff health and wellbeing and dealing with violence, racism, and sexual harassment in the NHS workplace. Additionally, we will roll out Staff Treatment Hubs that will ensure staff have access to high quality support for occupational health, including support for mental health and back conditions.

On 7 August 2025, the Government announced its plans to introduce measures to improve the safety of the cosmetics sector. This included prioritising the introduction of legal restrictions which will ensure that the highest risk cosmetic procedures are brought into Care Quality Commission regulation and can only be performed by specified regulated healthcare professionals.

In addition, the Government also committed to legislating to introduce a licensing scheme in England for lower risk procedures through powers granted through the Health and Care Act 2022. Under this scheme, which will be operated by local authorities, practitioners will be required to obtain a licence to perform specified cosmetic procedures, and the premises from which they operate will also need to be licensed. To protect children and young people, the Government is also committed to mandating age restrictions for cosmetic procedures.

The proposals will be taken forward through secondary legislation and therefore will be subject to the parliamentary process before the legal restrictions, or licensing regulations, can be introduced. We are now working with stakeholders to develop detailed plans and intend to consult on proposals for restrictions around the performance of the highest risk procedures in the spring.

Integrated care boards (ICBs) are responsible for commissioning local National Health Services, including ear wax removal services, and in doing so must consider how best to improve population health and achieve best value for money.

ICBs take account of relevant guidance on ear wax removal produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

Integrated care boards (ICBs) are responsible for commissioning local National Health Services, including ear wax removal services, and in doing so must consider how best to improve population health and achieve best value for money.

ICBs take account of relevant guidance on ear wax removal produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

We have done more than ever to prepare for winter this year with the development and better testing of winter plans. This includes surge capacity and escalation plans for urgent and emergency care.

The flu vaccination programme began on 1 September 2025 for children and pregnant women. Adults aged over 65 years old, those with long term health conditions, and frontline health and social care workers will start from 1 October 2025.

Further details of the plans for this year, including actions to reduce the effects of flu on demand for services, are set out in the Urgent and Emergency Care Plan for 2025/26, which is available at the following link:

https://www.england.nhs.uk/long-read/urgent-and-emergency-care-plan-2025-26/

On 16 September, the Secretary of State addressed a gathering of Chief Executives and undertook a joint visit with the NHS England Chief Executive to set out how winter preparations were being strengthened. A further meeting with Chief Executives on 3 November also focused on winter planning.

The Department does not have any operational fax machines or faxing facilities.

Data and research on detransition has been limited and the number of individuals who may wish to seek help from the National Health Service is not held.

In line with recommendation 25 of the Cass Review, NHS England is developing a clinical pathway for individuals who wish to detransition. Between October and December 2025, NHS England held a 'call for evidence' aimed at healthcare professionals and medical bodies, and the responses will help to shape the development of a care pathway and service specification which NHS England plans to consult on in the summer of 2026.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring that medicines, medical devices, and blood components for transfusions on the market in the United Kingdom are safe, effective, and manufactured to the highest standards of quality. The Medical Devices Regulations 2002 (MDR 2002) establish the statutory framework that medical devices must meet in order to comply with these standards.

All medical devices, including cerebrospinal fluid shunts programmable externally by magnets, must comply with the MDR 2002, which include bearing the UKCA or CE marking on the packaging or labelling of the device. Manufacturers or their UK representatives must monitor use of these devices when used in the UK. The manufacturer holds the legal responsibility for obtaining the necessary certification and registering their medical devices with the MHRA, the UK Competent Authority. Higher risk medical devices are assessed and approved by Approved Bodies in the UK or Notified Bodies in the European Union.

As part of meeting the requirements of the regulations, manufacturers have to provide instructions which would include any special operating instructions, any warnings and/or precautions to take, and precautions to be taken as regards exposure, in reasonably foreseeable environmental conditions, to magnetic fields. In addition, some manufacturers provide further standalone information on this topic, an example of which is available at the following link:

https://www.medtronic.com/en-us/l/patients/treatments-therapies/hydrocephalus-shunt/magnetic-field-influences.html

From this year, all drug and alcohol treatment and recovery funding will be channelled through the Public Health Grant, with over £13.45 billion allocated across three years, including £3.4 billion ringfenced for drug and alcohol treatment and recovery. Local authorities are responsible for commissioning drug and alcohol treatment and recovery services according to local need and can use this funding to support the families of individuals with a drug and/or alcohol treatment need.

The Department has published guidance specifically for adult treatment, and children and family services on how to effectively work together to support families affected by addiction. This is available at the following link:

https://www.gov.uk/government/publications/parents-with-alcohol-and-drug-problems-support-resources/parents-with-alcohol-and-drug-problems-guidance-for-adult-treatment-and-children-and-family-services

The Government’s ambition remains to reduce staff numbers by up to 50% across the Department, NHS England, and the integrated care boards, which is the equivalent to up to 18,000 posts, including a number of Civil Servants, through paid exits via voluntary exits and redundancies, natural attrition, and recruitment controls, combined together. These reductions will be made by March 2028. The overall cost of paid exits across organisations is estimated at approximately £1 billion to £1.3 billion. The calculations remain subject to ongoing policy development and refinement, and are also subject to actual take-up of exit schemes and calculated individual costs. Relevant, material financial information relating to this active policy development will be published in due course in line with transparency obligations. The Government remains committed to reducing unnecessary bureaucracy and duplication, to save more than £1 billion a year by the end of Parliament, which will go directly to improving patient outcomes.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

I refer the Hon. Member to the answer I gave on 2 February 2026 to Question 108759.

The Department has not made a specific assessment. Integrated care boards (ICBs) are responsible for commissioning local National Health Servies, including ear wax removal services, and must consider how best to improve population health and achieve best value for money.

ICBs commission these services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

The UK Foundation Programme Office (UKFPO) facilitates the operation and continuing development of the Foundation Programme. It is jointly funded and governed by NHS England and the four United Kingdom health departments.

All of the UKFPO’s administrative team are employees of the National Health Service, none are civil servants. Many of the team have wider experience of working in hospital settings directly with foundation doctors, or of working in foundation and medical education settings.

The UKFPO's National Clinical Director is a clinician, and the role of the Clinical Advisor for Recruitment is shared by two foundation school directors who are also both clinicians. The team is also directly responsible to medical directors in the four nation statutory education bodies (SEBs).

The UKFPO has a Foundation Recruitment Group which oversees its recruitment and allocation activity and processes. This group includes stakeholders like the Medical Schools Council, the British Medical Association, and medical school representatives, as well as the four nation SEBs.

The Department does not hold the data requested. The Department does though hold data from internal analysis that may give wider context to the question tabled and this is included below.

This analysis shows that of United Kingdom medical school students graduating in approximately 2012 to 2020, 93% of UK domiciled and 78% of non-UK domiciled students had entered the Foundation Programme year 2, as of 2024. Approximately 73% of UK and 55% of non-UK domiciled students had entered core/specialty training by 2024, though this number may rise further with time due to the level of competition to enter specialty medical training.

The following table shows the entrants to UK medical school from 2007 to 2015, tracked to registration with the General Medical Council (GMC) and entry to initial stages of NHS training, by domicile at entry to medical school:

Source: the Department of Health and Social Care’s analysis of UK Medical Education Database, Higher Education Statistics Agency, and General Medical Council data, may not match other sources.

Notes:

1. data is currently only available to March 2024;
2. the total entrants to the UK medical schools will include both those on UK Government funded places but also self-funded students at UK medical schools;
3. analysis only tracks doctors into NHS training, some graduates may be in UK medical employment outside the NHS such as research/academia/industry;
4. the numbers in specialty training may rise with time due to the competition in recruitment;
5. data is not held by year of graduation, however students starting medical schools in 2007 to 2015 will correspond approximately to graduates between 2012 to 2020, therefore this is a reasonable proxy for the requested graduate cohorts; and
6. the data represents the vast majority of UK medical students, although it may not match other sources of medical school entrant data as it includes only the four most common medical school courses.

The table above shows the entrants to UK medical schools between 2007 and 2015 by their domicile status at entry to medical school and the proportion who are then seen on the GMC register of doctors, those who have entered year one of foundation medical training, those who have entered year two of foundation medical training, and those who have entered the first level of core/specialty medical training. This analysis tracks medical students’ progress though NHS medical training up to 2024.