Department of Health and Social Care

The NHS Health Check (NHS HC) programme is commissioned by local authorities who are responsible for offering 100% of their eligible resident population a check every five years.

The Government's Public Health Grant to local authorities is used to enable the programme's provision and allows local authorities to ensure that delivery of the NHS HC is aligned with local public health services and fits their local population.

The programme's Best Practice Guidance provides commissioners and their providers with information on how to deliver the programme effectively, and how to adopt a proportionate universalist approach to ensure that checks are delivered in a way that prioritises resources and effort towards engaging people at higher risk of cardiovascular disease.

Department officials are considering options to improve the NHS HC programme.

The NHS Health Check programme, a core component of England's cardiovascular disease (CVD) prevention programme, assesses the top risk factors for CVD, including raised cholesterol, in eligible people and refers them to further support through behavioural interventions, clinical assessment, and treatment where appropriate. For every 1.4 million NHS Health Checks delivered annually, 900,000 people are found to have raised cholesterol level. We are also developing the NHS Health Check Online to improve access and help more people understand and act on their risk factors.

Furthermore, NHS England is strengthening lipid management by improving identification of people at risk of CVD through risk assessment, case finding, and community-based initiatives, including pharmacy-led approaches and cholesterol point of care testing.

The Government recently published the Cardiovascular Disease Modern Service Framework, which sets out priorities for the health and care system to accelerate progress on the ambition to reduce premature deaths from heart disease and stroke by 25% within the next decade. Identifying people with high cholesterol and optimising lipid management for people with high cholesterol are amongst the priorities for the health and care system.

The NHS Health Check (NHS HC) aims to improve the health and wellbeing of adults aged 40 to 74 years old through the promotion of early awareness, assessment, and management of the major risk factors for cardiovascular disease (CVD), risk factors that are associated with premature death, disability, and health inequalities in England. Improving uptake of the programme, including for people at the highest risk and experiencing inequalities, is a priority for the programme.

The NHS Health Check Online is currently being tested in 11 local authorities across England and aims to increase access and engagement with the programme for all population groups, by allowing people to undertake their NHS Health Check at home, at a time and place convenient to them, freeing up in-person NHS HCs for those who want or need more support.

The recently published Cardiovascular Disease Modern Service Framework (CVD MSF) sets out the 10-year ambition to systematically identify individuals with established or emerging cardiovascular, kidney, and metabolic risk factors, including via the NHS HC, whilst reducing the variation in the number of people receiving a check between the best and worst performing areas nationally. A delivery plan will be published later this year to support local implementation of the CVD MSF.

The Government recognises that many respiratory diseases are associated with preventable risk factors, including smoking, air pollution, occupational exposures, poor housing conditions, and delayed diagnosis.

Data published by the Office for Health Improvement and Disparities shows that the under 75 year old mortality rate from respiratory disease considered preventable in England was 19.6 deaths per 100,000 population in 2024.

The Government is taking action to reduce respiratory disease morbidity and mortality through measures that prevent disease, improve early diagnosis, and support effective treatment, including implementation of the Tobacco and Vapes Act, support for local smoking cessation services, improvements in air quality, vaccination programmes against respiratory infections, and delivery of NHS Long Term Plan commitments on respiratory disease.

NHS England's National Respiratory Programme is focused on improving outcomes for people with respiratory disease through earlier diagnosis, better disease management, and access to effective and innovative treatments. This includes improving access to quality-assured spirometry, pulmonary rehabilitation, and earlier diagnosis of conditions such as asthma and chronic obstructive pulmonary disease (COPD), supported by commissioning standards and guidance for commissioners.

NHS England, working with Health Innovation Networks, has also established a multi-year Respiratory Transformation Partnership to identify scalable approaches to reducing premature mortality, improving disease recognition, supporting the consistent delivery of National Institute for Health and Care Excellence recommended care, and increasing access to existing and emerging biologic therapies for people living with asthma and COPD. A nationally coordinated evaluation will support evidence generation, shared learning, and future investment decisions.

The National Cancer Plan sets out a modern cancer care model that is more personalised, coordinated and delivered closer to home where clinically appropriate. The Neighbourhood Health Service will support delivery of this model by bringing elements of cancer care into community settings such as neighbourhood health centres, alongside other local services.

Multi-disciplinary neighbourhood teams will coordinate care around the individual, including those with blood cancer, helping to reduce fragmentation between services, improve integration across health and community provision, and better align care with people’s day-to-day lives.

Furthermore, in 2025, we published Standardising Community Services which provides an overview of community health services. Further guidance was published in February 2026, providing more detailed descriptions of the core components of community health services for integrated care boards, and a copy of this is attached.

Clear definitions of core community health services will enable systems to measure demand, capacity and workforce, and streamline services to reduce unwarranted variations, including for cancer care. This guidance will also support commissioners in making investment choices when designing neighbourhood health services and in moving more care into the community.

We need to ensure that staff across the health and care system are supported to work as effectively as possible for their populations, in joined-up, integrated neighbourhood teams. That is why neighbourhood health is designed to support them, by bringing professionals together in new neighbourhood teams to cut duplication and use digital tools to make their day-to-day work more efficient so they can focus on patient care.

The National Cancer Plan sets out a modern cancer care model that is more personalised, coordinated and delivered closer to home where clinically appropriate. The Neighbourhood Health Service will support delivery of this model by bringing elements of cancer care into community settings such as neighbourhood health centres, alongside other local services.

Multi-disciplinary neighbourhood teams will coordinate care around the individual, including those with blood cancer, helping to reduce fragmentation between services, improve integration across health and community provision, and better align care with people’s day-to-day lives.

Furthermore, in 2025, we published Standardising Community Services which provides an overview of community health services. Further guidance was published in February 2026, providing more detailed descriptions of the core components of community health services for integrated care boards, and a copy of this is attached.

Clear definitions of core community health services will enable systems to measure demand, capacity and workforce, and streamline services to reduce unwarranted variations, including for cancer care. This guidance will also support commissioners in making investment choices when designing neighbourhood health services and in moving more care into the community.

We need to ensure that staff across the health and care system are supported to work as effectively as possible for their populations, in joined-up, integrated neighbourhood teams. That is why neighbourhood health is designed to support them, by bringing professionals together in new neighbourhood teams to cut duplication and use digital tools to make their day-to-day work more efficient so they can focus on patient care.

Neither the Department nor NHS England hold this information.

NHS England has a published service specification that covers the provision of surgical interventions for individuals on the National Health Service pathway of care for the treatment of gender dysphoria. Providers are expected to follow this service specification.

Continence is an important component in a person’s health and well-being at any stage of life. Early assessment by an appropriately trained professional allows a patient centred care pathway to be followed.

The Renewed Women's Health Strategy for England, published in April 2026, recognises that these conditions are often normalised by women and girls themselves and by wider society, with many women viewing symptoms such as leaking as an inevitable part of pregnancy, childbirth, ageing or the menopause. It also recognises that many women feel too embarrassed to seek support, which can lead to delays in diagnosis and treatment. The Women’s Health Strategy is not condition specific, instead it focuses on systemic changes including redesigning services, improving diagnosis, and embedding women and girls’ voices so that care improves across all conditions. It sets out how the Government will make women and girls’ voices and choices central in healthcare, transform National Health Service performance in services that matter most to women, support all women to live healthy, prosperous lives and create an approach to research and development that works for and empowers women.

Where medical records are shared across National Health Service organisations, such as the Shared Care Record program, organisations should complete a Data Protection Impact Assessment. This allows them to consider the data protection and confidentiality risks involved, and outlines what actions they can take to mitigate the risk to an acceptable level. NHS England has published guidance on this subject, Information Governance Framework: Shared Care Records, a copy of which is attached.

NHS England has undertaken further due diligence on the data sources that will underpin the study, and taken time to re-engage with data-sharing organisations, on which the study will be dependent, including refining the study design and data sharing requirement following discussion with adult gender clinics.

We now expect all commissioned adult gender services to collaborate with the study to enable its successful completion.

The Department continues to support NHS England in progressing the study.

No disciplinary action has been taken.

NHS England has undertaken further due diligence on the data sources that will underpin the study, and taken time to re-engage with data-sharing organisations, on which the study will be dependent, including refining the study design and data sharing requirement following discussion with adult gender clinics.

We now expect all commissioned adult gender services to collaborate with the study to enable its successful completion.

The Department continues to support NHS England in progressing the study.

No disciplinary action has been taken.

There is an established system in place for the declaration and management of Non-Executive Director’s interests. Mr Milburn’s declarations of interest are published on the GOV.UK website and are as referenced in the previously given answer of 16 June 2026 to Question HL106, which is in line with the Cabinet Office guidance.

Whilst it is possible, it is not mandatory for trusts to record second trimester miscarriage through the Maternity Services Data Set (MSDS). The requirements for the next iteration for the MSDS include more detailed data collection around pregnancy outcomes, including on miscarriage. Timescales for this next iteration are yet to be confirmed.

There are no specific plans to update the Digital Maternity Record Standard at present, as the current version has yet to be fully implemented by all maternity system suppliers. However, this will be considered as part of wider maternity data architecture design work, which will also support the MSDS and the Single Patient Record.

Whilst it is possible, it is not mandatory for trusts to record second trimester miscarriage through the Maternity Services Data Set (MSDS). The requirements for the next iteration for the MSDS include more detailed data collection around pregnancy outcomes, including on miscarriage. Timescales for this next iteration are yet to be confirmed.

There are no specific plans to update the Digital Maternity Record Standard at present, as the current version has yet to be fully implemented by all maternity system suppliers. However, this will be considered as part of wider maternity data architecture design work, which will also support the MSDS and the Single Patient Record.

The Cass Review concluded that the percentage of people who subsequently detransition following medical intervention remains unknown due to the lack of long-term follow-up studies.

In response to the recommendations of the Cass Review and the Operational and Delivery Review of Adult Gender Services, NHS England plans to consult on a service specification for a detransition pathway later this year, an element of which will be proposals for building the evidence through data collection, formal research and clinical audit.

NHS Supply Chain has worked closely with the Department to support the implementation of its value based procurement (VBP) guidance. Within the Total Cardiology and Vascular Solutions Framework, the Department’s methodology has been piloted on a national procurement and integrated into the non-financial evaluation criteria, with appropriate adaptations made to reflect the specific clinical and operational requirements of the specialty. Value-based assessment criteria and associated non-financial questions have been included where supplier claims can be objectively assessed ensuring a fair, transparent, and equitable evaluation process.

Extensive pre-market engagement was undertaken between March 2025 and September 2025, providing suppliers, customers, clinical associations, and professional bodies with the opportunity to share insights, feedback, and observations on the proposed procurement strategy and overall approach. Communication has been conducted in forms such as team meetings, face to face meetings, and email exchanges with all stakeholders, including clinicians. Draft versions of the VBP questions were circulated during this period to support supplier readiness and to enable meaningful challenge and feedback in advance of tender publication. NHS Supply Chain clinical and category teams engaged extensively with key clinical stakeholder groups, including members of the British Heart Rhythm Society, members of the British Cardiovascular Intervention Society, and NHS England Device Working Groups, to inform the development and refinement of the VBP criteria. The final questions focus on areas where value can be clearly evidenced, including clinical outcomes, innovation, sustainability, social value, and whole-system costs and efficiencies.

While the NHS Supply Chain has successfully incorporated VBP principles into the cardiology and vascular framework evaluation, a key challenge remains the limited availability of standardised Patient Reported Outcome Measures, clinical registries, and other robust outcome datasets to enable consistent and comparable assessment of supplier value claims. Consequently, VBP evaluation has been focused on evidence that can be objectively assessed at the tender stage, with a clear commitment to further validate and measure value throughout the lifetime of the framework as more comprehensive clinical, operational, and patient outcome data becomes available. This approach balances fairness and transparency in procurement with the longer-term ambition of embedding a mature, evidence-based value assessment model across the specialty.

NHS Supply Chain has worked closely with the Department to support the implementation of its value based procurement (VBP) guidance. Within the Total Cardiology and Vascular Solutions Framework, the Department’s methodology has been piloted on a national procurement and integrated into the non-financial evaluation criteria, with appropriate adaptations made to reflect the specific clinical and operational requirements of the specialty. Value-based assessment criteria and associated non-financial questions have been included where supplier claims can be objectively assessed ensuring a fair, transparent, and equitable evaluation process.

Extensive pre-market engagement was undertaken between March 2025 and September 2025, providing suppliers, customers, clinical associations, and professional bodies with the opportunity to share insights, feedback, and observations on the proposed procurement strategy and overall approach. Communication has been conducted in forms such as team meetings, face to face meetings, and email exchanges with all stakeholders, including clinicians. Draft versions of the VBP questions were circulated during this period to support supplier readiness and to enable meaningful challenge and feedback in advance of tender publication. NHS Supply Chain clinical and category teams engaged extensively with key clinical stakeholder groups, including members of the British Heart Rhythm Society, members of the British Cardiovascular Intervention Society, and NHS England Device Working Groups, to inform the development and refinement of the VBP criteria. The final questions focus on areas where value can be clearly evidenced, including clinical outcomes, innovation, sustainability, social value, and whole-system costs and efficiencies.

While the NHS Supply Chain has successfully incorporated VBP principles into the cardiology and vascular framework evaluation, a key challenge remains the limited availability of standardised Patient Reported Outcome Measures, clinical registries, and other robust outcome datasets to enable consistent and comparable assessment of supplier value claims. Consequently, VBP evaluation has been focused on evidence that can be objectively assessed at the tender stage, with a clear commitment to further validate and measure value throughout the lifetime of the framework as more comprehensive clinical, operational, and patient outcome data becomes available. This approach balances fairness and transparency in procurement with the longer-term ambition of embedding a mature, evidence-based value assessment model across the specialty.

Community diagnostic centres (CDCs) offer patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially speeding up the start of treatment. CDCs are part of the Government’s aim to shift care out of hospitals and into communities.

NHS England publishes guidance to integrated care boards (ICBs) on CDCs. The 2026 version of the guidance will be published imminently. The guidance sets out the core tests for a CDC. The following table shows the overall type of core diagnostic tests available, as well as the individual modalities:

In addition, the following table shows the overall type of optional diagnostic tests available, as well as the individual modalities:

Data is not collected on timely access to diagnostic services for those from underrepresented groups including women, and those from poorer socioeconomic backgrounds.

One of the central priorities for CDCs is to offer tests for underserved populations. That is why the vast majority of CDCs are located in, or within easy public transport access from, the areas with the most deprivation and health inequalities in each ICB.

Community diagnostic centres (CDCs) offer patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially speeding up the start of treatment. CDCs are part of the Government’s aim to shift care out of hospitals and into communities.

NHS England publishes guidance to integrated care boards (ICBs) on CDCs. The 2026 version of the guidance will be published imminently. The guidance sets out the core tests for a CDC. The following table shows the overall type of core diagnostic tests available, as well as the individual modalities:

In addition, the following table shows the overall type of optional diagnostic tests available, as well as the individual modalities:

Data is not collected on timely access to diagnostic services for those from underrepresented groups including women, and those from poorer socioeconomic backgrounds.

One of the central priorities for CDCs is to offer tests for underserved populations. That is why the vast majority of CDCs are located in, or within easy public transport access from, the areas with the most deprivation and health inequalities in each ICB.

Community diagnostic centres (CDCs) offer patients a wide range of diagnostic tests closer to home and greater choice on where and how they are undertaken, reducing the need for hospital visits and potentially speeding up the start of treatment. CDCs are part of the Government’s aim to shift care out of hospitals and into communities.

NHS England publishes guidance to integrated care boards (ICBs) on CDCs. The 2026 version of the guidance will be published imminently. The guidance sets out the core tests for a CDC. The following table shows the overall type of core diagnostic tests available, as well as the individual modalities:

In addition, the following table shows the overall type of optional diagnostic tests available, as well as the individual modalities:

Data is not collected on timely access to diagnostic services for those from underrepresented groups including women, and those from poorer socioeconomic backgrounds.

One of the central priorities for CDCs is to offer tests for underserved populations. That is why the vast majority of CDCs are located in, or within easy public transport access from, the areas with the most deprivation and health inequalities in each ICB.

We know that people are waiting too long for community services. That is why, for the first time, we have set a clear target for systems to work to reduce long waits. By 2028/29, at least 80% of community health services activity should take place within 18 weeks, bringing community health services in line with targets for elective care.

In 2025, we published Standardising Community Health Services which provides an overview of core community health services. Setting clear expectations of the core community health services, integrated care boards will support consistent delivery of community health services and effective commissioning, and will improve patient access to care.

NHS England works with local systems, including integrated care boards, to manage demand and mitigate the impact of waiting times on patients, particularly in areas of highest clinical risk. Community health services waiting time data is monitored nationally through NHS England's monthly Community Health Services Situation Report.

No target has been removed from the Modern Service Framework for Frailty and Dementia. The framework is still in development, and we are still considering all options to help improve dementia diagnosis and care, including reviewing targets, metrics, and data.

We are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with frailty and dementia. As part of this exercise, we will develop a list of best evidenced interventions following analysis of the evidence and wider research.

From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.

The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.

Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.

We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.

From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.

The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.

Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.

We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.

From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.

The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.

Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.

We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.

From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.

The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.

Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.

We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.

From April 2027, integrated care boards (ICBs) will take on responsibility and accountability for commissioning vaccination services. This includes taking on responsibility for improving uptake towards the targets for vaccination coverage which are currently set out as key performance indicators in the National Health Service public health functions agreement 2026 to 2027. These targets will be maintained through delegation.

The NHS Oversight Framework provides a consistent approach to assessing how well providers and ICBs are delivering for patients and supporting improvement. Uptake of the measles, mumps, rubella and varicella vaccine and healthcare worker flu vaccine are included in the metrics used to assess ICB performance. The Department is continuing to develop the detail of our approach to oversight and accountability of the system as part of the transformation to merge NHS England into the Department.

Throughout this period and beyond we will continue to support new vaccination programmes with clear, time-bound delivery plans working with national partners, including the UK Health Security Agency, and partners throughout the system including, from April 2027, offices for pan-ICB commissioning and ICBs.

We will also continue to support commissioners to arrange high-quality vaccination services including supporting a strong core offer through general practice and school-age immunisation services as well as the arrangement of effective supplementary and targeted outreach services that drive uptake where needed and appropriate for population health needs.

The information requested is not held or routinely published.

The UK Health Security Agency’s (UKHSA) English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) publishes surveillance data on antibiotic-resistant infections, including estimates of 30-day all-cause mortality following resistant bloodstream infections. However, these figures are not a measure of deaths attributable to antimicrobial resistance and should not be interpreted as deaths caused by antibiotic-resistant infections. This surveillance data is available on the GOV.UK website.

The UKHSA publishes case-fatality statistics for healthcare-associated infections, which are available on the GOV.UK website, including methicillin-resistant staphylococcus aureus. However, these cannot be used to determine deaths attributable to antibiotic resistance because they do not distinguish the effect of resistance from other factors such as underlying illness, age, comorbidities, or the infection itself.

There is no breakdown of the statistics by National Health Service estate.

The ESPAUR’s 2024 to 2025 report included a breakdown by hospital- and community-onset infection but did not include place of death and cannot determine the proportion of deaths occurring in hospital.

The UKHSA is now developing the capability to produce annual estimates of deaths attributable to antibiotic-resistant bloodstream infections as part of the United Kingdom’s 2024 to 2029 national action plan for antimicrobial resistance, which is available on the GOV.UK website.

Supporting perinatal mental health and parent-infant relationships are vital to the health and wellbeing of babies and their caregivers.

The Department is investing £200 million for Healthy Babies services in 75 local authority areas with high levels of deprivation, including £109 million to provide enhanced parent-infant relationship and perinatal mental health support. This forms part of a £900 million package in Best Start Family Hubs and Healthy Babies to create a more integrated, accessible system of support for families.

All Best Start Family Hubs should provide safe and inclusive perinatal mental health support, identifying needs early, offering emotional support and help families to access appropriate support and services within their local area. Healthy Babies funded areas are expected to deliver an enhanced perinatal mental health service, with proactive identification, accessible support, and clear referral pathways. These services complement National Health Service provision for parents with moderate to severe perinatal mental health needs.

The Food Standards Agency (FSA) is currently exploring a wide set of reforms to the existing food system, and this will include consideration of a statutory Food Hygiene Rating Scheme in England. As part of this work, the FSA will review the available legislative options and update its assessment of the associated costs and benefits of a statutory scheme. Ministers will consider proposals in due course.

The National Institute for Health and Care Excellence (NICE) highly specialised technologies programme (HST) is reserved for the evaluation of a small number of medicines licensed for the treatment of very rare, very severe diseases. Decisions on whether medicines are routed to the HST programme are taken against a set of published criteria that were updated in April 2025 following public and stakeholder engagement. The purpose of the new criteria is not to change the number or nature of the topics evaluated through the HST programme, but to ensure that the criteria are sufficiently clear and predictable for companies and patient groups and are aligned to the HST vision.

The Government has recently announced a number of pilots and projects following the United States and Untied Kingdom partnership on pharmaceuticals that will shape a commercial environment that actively encourages innovation and improves patient access. As part of that work, NICE will review the approach to valuing rare disease medicines through its Health Technology Assessment Innovation Laboratory. This research will consider both technology appraisal and highly specialised technologies routes. The review will assess a range of both radical and incremental options to improve the current framework.

The investment in focal therapies, announced on 2 June 2026, will strengthen existing provision in line with the expansion of the TRANSFORM trial for prostate cancer screening.

Any expansion of focal therapy provision to new sites will include appropriate clinical and market engagement. Officials at the Department are working closely with clinicians and researchers to optimise the planned investment of up to £2.8 million in focal therapy. Further details of this investment will be announced in due course.

The Department of Health and Social Care is working with partners including the Department for Culture, Media and Sport, Arts Council England, and the National Centre for Creative Health to understand and develop the evidence base and consider the policy implications.

The Government is deeply concerned that too many adults, children, and young people with attention deficit hyperactivity disorder (ADHD) and autism are not getting the support they need early enough, consistently enough, or in ways that are well matched to their needs. There is a range of cross-Government work underway that is examining the impacts of neurodevelopmental conditions on health, education, and employment, and how people can be supported earlier and more effectively.

In December 2025, the Government launched an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. The final report, due in the summer, will make recommendations on how the Government, the health system, and wider public services can respond to increasing demand for support more fairly and effectively so that people receive the right support, at the right time, in the right place.

We are also committed to transforming outcomes for children, young people, and their families with special educational needs and disabilities (SEND) through pivotal reforms. We want these reforms to support the treatment to prevention shift in our 10-Year Health Plan and its focus on early identification of needs, support, and intervention, enabling more children to access support and thrive in inclusive mainstream settings.

Central to this is the new Experts at Hand offer, backed by £1.8 billion over three years, which will bring health and education professionals around mainstream settings. Alongside this, £1.6 billion will be invested over the next three years to make the mainstream system more inclusive, building on the latest evidence and practice. By 2028, up to £15 million will have been invested to build the evidence base for, and then provide, national inclusion standards. These will set out, for the first time, what support should be available in every mainstream setting. We will also refresh areas of need, update guidance on reasonable adjustments, and revise the SEND Code of Practice.

The Timms Review, the first review of the Personal Independence Payment benefit, is examining how it can better support disabled people to live independently and access the right support at the right level. The review is due to report in the autumn. Additionally, the Milburn Review on Young People and Work is examining how health conditions can affect participation in education, employment, and training, and the implications for welfare dependency. It published its interim report on 28 May, with the final report due to be published later this year.

The Government will consider the findings of these reviews to inform future Government decisions.

Dance is recognised within the Chief Medical Officer’s Guidelines on Physical Activity as a form of physical activity that can improve health at every stage of the life course. Dance is a broad discipline of creative activity from ballet to street dance, and the evidence of potential health benefits spans informal dancing through structured dance classes to clinical dance therapies.

The Department of Health and Social Care is working with partners including the Department for Culture, Media and Sport, Arts Council England, and the National Centre for Creative Health to understand and develop the evidence base and consider the policy implications for creative health to improve health outcomes and support delivery of the 10-Year Health Plan.

One specific example of the evolving collaboration is that in Spring 2026, NHS South West worked with Let’s Dance and Parkinson’s UK to raise awareness of the evidence of impact of dance on both physical and mental health symptoms of Parkinson’s disease through targeted amplification of the national Let’s Dance campaign to patients and clinicians. This work was amplified nationally, and further work is being take forward to explore further scaling for the 2027 Let’s Dance campaign.

The Government has heard from a range of industry and medical stakeholders and will consider the range of views provided in relation to potential exemptions. There will be close liaison with the Care Quality Commission (CQC) to ensure that everyone either participating in or attending cultural or sporting events receive safe and effective care. The CQC continues to engage with providers to ensure minimal impact on them whilst achieving those aims.

The Care Quality Commission (CQC) regulates the treatment of disease, disorder, and injury across a range of industries, which includes pre-hospital care. The CQC continues to engage with providers of event healthcare directly, and has worked with the Government to meet with industry and medical leaders. This engagement continues.

In accordance with its normal ways of working, the CQC will recruit a team of specialist advisors who are experts in their field to join the inspections of providers. The purpose of that inclusion is to ensure that all regulatory decisions are based upon current best practice. The CQC continues to monitor the implementation of the review of regulations to ensure that financial matters have due attention.

The Government itself has not made an overall economic assessment of the impact of attention deficit hyperactivity disorder (ADHD) and neurodivergence. However, the independent ADHD Taskforce, which reported in 2025, reported that currently the estimated economic costs of not treating ADHD are approximately £17 billion to the United Kingdom’s economy. Three relevant ongoing reviews will help the Government better understand the issues and how they could be addressed.

The Government announced on 4 December 2025 the launch of an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism. The final report, due in the summer, will make recommendations on how the Government, the health system, and wider public services can respond to increasing demand for support more fairly and effectively so that people receive the right support, at the right time, in the right place.

The next stage of the review will look at service design and how services might respond more effectively to rising need, including the role of earlier intervention, community-based provision, and more integrated pathways across health, education, and other public services. The review will also look at the question of what role the private sector plays in diagnostic services.

The Timms Review, the first review of the Personal Independence Payment benefit, is examining how it can better support disabled people to live independently and access the right support at the right level. It published its interim report on 15 July 2026, with the final review due to report in the autumn. Additionally, the Milburn Review on Young People and Work is examining how health conditions, including ADHD and autism, can affect participation in education, employment, and training, and the implications for welfare dependency. It published its interim report on 28 May, with the final report due to be published later this year. The Government will consider the findings from these reviews, alongside those of the Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism.

The Care Quality Commission (CQC) is the regulator for health and social care in England. Providers of health and adult social care who are wholly based outside England would typically not register with the CQC.

This is because the CQC does not hold jurisdiction to regulate providers outside England and therefore cannot inspect and take enforcement action against them if the service being provided fails to meet the necessary standards as set out in the regulations.

Analysis of 2025 Fracture Liaison Services (FLS) data shows that the number of FLS’ in England has increased since 2024, from 80 to 83. These 83 services are based in 23 out of the 25 integrated care board (ICB) clusters.

Analysis of the 2025 data suggests that no ICB clusters had an FLS in each of the NHS hospitals within the ICB clusters. The number of FLS’ per ICB cluster ranged from one to eight.

No specific assessment has been made. The Government recognises how important it is that patients with rare diseases are able to benefit from access to effective new medicines. The National Institute for Health and Care Excellence (NICE) has a strong track record in supporting access to new medicines for patients with rare diseases with 89% of the rare disease medicines that it has appraised since March 2024 recommended for some or all of the eligible patient population.

Through the Life Sciences Sector Plan and the 10-Year Health Plan, we are taking steps to make the United Kingdom a faster place to approve and adopt new medicines. This includes wider use of real-world evidence, more flexible commercial deals, faster NICE guidance, and a new joint NICE and Medicines and Healthcare products Regulatory Agency pathway to shorten the time from approval to National Health Service use.

We recognise that there is more to do to improve and accelerate access to new medicines for NHS patients and the steps that we are taking as part of the pharmaceuticals partnership with the United States are already resulting in medicines, including medicines for patients with rare diseases, becoming available to NHS patients that may not otherwise have been recommended.

NHS England plans to publish proposed clinical commissioning policies for the use of masculinising and feminising hormones in adult gender services later in the summer, for the purpose of public consultation. Separately, NHS England plans to publish new service specifications for adult gender services, for the purpose of public consultation, later this year.

The National Consultant Information Programme (NCIP) is publicly accessible to patients on the Getting It Right First Time website.

The NCIP portal is a free data platform containing consultant and provider-level activity and outcomes data for over 500 procedures in 13 surgical specialties. It covers National Health Service practices, NHS funded work in the independent sector, and privately funded work carried out in the NHS. Over time, the ambition is to add independent sector data, to provide a single repository of whole practice. Currently, patients are not able to access this data.

NCIP allows consultants in 13 surgical specialties to access their individual outcomes data, for personal learning, clinical governance, and appraisals. NCIP does not record practising privileges in the independent sector.

NCIP is a critical part of the response to the Paterson Inquiry, which recommended that there should be a single repository of the whole practice of consultants across England. By sharing high-quality outcome data, consultants, their appraisers, and responsible officers can compare outcomes for their practice or use peer review to improve their performance in a way that is measurable and objective, leading to better safety and efficiency across the NHS.