Department of Health and Social Care

The Adult Oral Health Survey 2023 provides the first picture of adult oral health in England for more than a decade. It provides further evidence of the need for dental contract reform.

We are taking forward significant changes to the National Health Service dental contract. The reforms will prioritise patients with urgent dental needs and those requiring complex treatments, and will come in from April 2026. We are committed to fundamental reform of the NHS dental contract by the end of this Parliament, with a focus on improving access, promoting prevention, and rewarding dentists fairly.

The Government is also focussed on prevention of poor dental health through our supervised toothbrushing programme to reach up to 600,000 children in the 20% most deprived areas of England, and by expanding community water fluoridation to the North East of England. This intervention will reach an additional 1.6 million people and will reduce tooth decay and inequalities in dental health, particularly in children and vulnerable adults.

There are beneficial effects of accredited qualifications and structured learning on the recruitment and retention of care workers. Skills for Care data shows that turnover rates are approximately 10% lower for staff who hold a relevant qualification compared to those without. Additionally, staff who received more than 30 instances of training evidenced a turnover rate 3.4% lower than those who recorded only one to five instances, with further information available in Skills for Care’s the ‘State of’ report at the following link:

https://www.skillsforcare.org.uk/Adult-Social-Care-Workforce-Data/workforceintelligence/Reports-and-visualisations/National-information/The-State-of-report.aspx

The Department introduced the Care Workforce Pathway, the first universal career structure for adult social care, which sets out clear skills, and progression routes to help retain staff and attract newcomers by recognising care workers as professionals and promoting development opportunities.

Additionally, we launched the Learning and Development Support Scheme, which provides funding support for training, including recognised qualifications like the Level 2 Adult Social Care Certificate, which provides a portable, recognised foundation of skills and knowledge, aiming to reduce duplication of training and increase retention. Furthermore, the Quality Assured Care Learning Service ensures training is high-quality, meets sector needs, and supports career growth.

Under the Care Act 2014, local authorities must keep care and support plans under review, respond to reasonable requests for review, and update plans when circumstances change, involving the individual drawing on care and support, and their carer, if applicable, throughout.

Local authorities should establish systems that allow the proportionate monitoring of both care and support plans to ensure that needs are continuing to be met. In the absence of any request of a review, or any indication that circumstances may have changed, the local authority should conduct a periodic review of the plan. It is the expectation that local authorities should conduct a review of the plan no later than every 12 months after the plan is first agreed or last reviewed.

The Care Quality Commission (CQC) is assessing how local authorities in England are meeting the full range of their duties under Part 1 of the Care Act 2014, including how local authorities assess the needs of individuals who draw on care and support. The assessments identify local authorities’ strengths and areas for improvement, facilitating the sharing of good practice and helping us to target support where it is most needed. If the CQC identifies that a local authority has failed or is failing to discharge its duties under the Care Act to an acceptable standard, my Rt Hon. Friend, the Secretary of State for Health and Social Care, has powers to intervene. Reports are made available on the CQC’s website, at the following link:

www.cqc.org.uk/care-services/local-authority-assessment-reports

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

The MSF will drive improvements in the services that patients and their families, including those in Yeovil, receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care.

The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that integrated care boards should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.

We are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care. St Margaret’s Hospice Care, which serves patients in the Yeovil constituency, is receiving £816,184 from this funding.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

The MSF will drive improvements in the services that patients and their families receive at the end of life and enable integrated care boards to address challenges in access, quality and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

Integrated care boards (ICBs) are responsible for commissioning primary and secondary eye care services to meet local need. NHS sight tests are widely available across the country. The decision to commission enhanced eye care services will be determined by local ICBs following a local needs assessment.

ICBs are required to work with local authorities to assess the current and future health, care and wellbeing needs of their local populations. They will then set out in joint local health and wellbeing strategies how they will meet those needs, which could include addressing any identified inequalities in accessing services. ICBs will also want to take account of published waiting list information which is broken down by demographics to allow greater visibility of potential health inequalities.

The Government has instructed the National Health Service to improve maternity services, as part of a drive to improve quality, as a priority in the Medium‑Term Planning Framework.

While the ringfence has been removed, the same level of funding is being delivered to allow local healthcare system leaders more autonomy to meet the needs of their local population. This approach is consistent with our wider approach to give local healthcare leaders, who are best placed to decide how to serve their local community, more flexibility.

Baroness Amos is leading a rapid, independent investigation in NHS Maternity and Neonatal services to help us understand the systemic issues behind why so many women, babies and families experience unacceptable care. The investigation will look into the maternity and neonatal system nationally, bringing together the findings of past reviews into one clear national set of recommendations. This will also include local investigations of maternity and neonatal services in selected trusts.

On 9 December, Baroness Amos published reflections on what she has heard so far as part of the National Maternity and Neonatal Investigation, following engagement with women and families. Baroness Amos’ reflections and initial findings are available at the following link:

https://www.matneoinv.org.uk/

The Department has not conducted any such review, but this information is available via the NHS England Innovation Scorecard, which is published bi-annually.

Across all disease areas, though the 10-Year Health Plan and the Life Sciences Sector Plan, the Government has commitment to reducing friction in the system to optimise access and uptake of new medicines so the most clinically and cost-effective can reach patients faster. These actions will speed up market access for new medicines and reduce local unwarranted variation in medicine use.

Integrated care boards are responsible for commissioning services to meet the health needs of their local population, which includes responsibility for ensuring that there is adequate provision of British Sign Language (BSL) interpreters to support deaf patients in the community.

We welcome the British Sign Language Advisory Board’s report titled Locked out: Exclusion of deaf and deafblind BSL users from health and social care in the UK. We will carefully consider its recommendations, including how, in the context of our work on the 10-Year Health Plan and reform of adult social care, we can improve the experiences of Deaf people when accessing health and care services and experience of Deaf people.

NHS England commissions prison health care services into every prison in England. Every prison has onsite health care services including, primary care, mental health, dentistry, and substance misuse teams. This includes the care and management of those with long term conditions such as diabetes. All prisons offer a range of appointments to meet the needs of patients, and this includes routine appointments and urgent appointments.

NHS England commissions health care in prison that is the equivalence of community health care. The National Service Specification for primary care defines what this means for patients who require support. Access to health provision is available to every person in prison at any stage of their sentence, and this begins at the point of entry. NHS England also commissions health needs assessments across prisons to determine the needs and requirements of the prison population.

NHS England is reviewing the National Primary Care Service Specification to ensure it continues to meet the needs of the prison population.

NHS England commissions prison health care services into every prison in England. Every prison has onsite health care services including, primary care, mental health, dentistry, and substance misuse teams. This includes the care and management of those with long term conditions such as diabetes. All prisons offer a range of appointments to meet the needs of patients, and this includes routine appointments and urgent appointments.

NHS England commissions health care in prison that is the equivalence of community health care. The National Service Specification for primary care defines what this means for patients who require support. Access to health provision is available to every person in prison at any stage of their sentence, and this begins at the point of entry. NHS England also commissions health needs assessments across prisons to determine the needs and requirements of the prison population.

NHS England is reviewing the National Primary Care Service Specification to ensure it continues to meet the needs of the prison population.

To deliver the shift from analogue to digital that is set out in the 10-Year Health Plan, we will create a digital front door for mental health care through the NHS App to boost access to early support and empower people to take steps to manage their symptoms.

Digital and artificial intelligence (AI) tools in mental health care can enhance and complement the work of qualified counsellors and psychotherapists, not replace human-delivered care. These tools can help with routine tasks like managing appointments, answering basic queries, updating clinical notes, and booking sessions. This means that clinicians can spend more time providing care to patients and patients have an improved experience across the care pathway, for example through reduced waiting times. Any new tools are introduced within a comprehensive regulatory framework in the National Health Service, underpinned by rigorous standards for safety, effectiveness, ethics, and data protection.

Publicly available AI applications that are not deployed by the NHS, such as ChatGPT and Character.AI, are not regulated as medical technologies and may offer incorrect or harmful information. Users are strongly advised to be careful when using these technologies.

The NHS App is at the forefront of a major digital transformation and will revolutionise access to healthcare by putting patients at the centre of a modern, personalised, and data-driven service. One of the key aims is to empower individuals with greater choice, transparency, and control over their care.

The NHS App is co-designed with patients from a wide range of background and needs, with 14,000 users involved in user research in 2025 alongside 42,000 survey completions. Our research teams also have a rule of always doing rounds of research with often excluded or disadvantaged groups. This is often facilitated by partners like the Royal National Institute of Blind People and Mencap who help us to involve the appropriate people.

The NHS App is already helping people manage their health more easily, whether that’s viewing records, booking appointments, ordering prescriptions, or accessing test results. In the past year alone, the app has sent over 181 million messages, supported over 32 million vaccination invites, and offered more than 16 million vaccination appointments, many in local pharmacies. These numbers show how the app is not just supporting care but actively shifting it closer to home.

By 2030, patients will be able to manage their care remotely, contribute to their health records, and navigate the system with confidence, driving better outcomes and a more integrated, responsive National Health Service.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.

Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.

NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.

This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.

This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.

Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.

NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.

This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.

This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

The National Institute for Health and Care Excellence (NICE) has not classified terminal cancer as moderately severe. The NICE is an independent body and is responsible for developing the methods and processes it uses to evaluate whether new medicines should be recommended for routine National Health Service funding.

In developing recommendations on whether medicines represent a clinically and cost effective use of NHS resources, NICE is able to apply a weighting that recognises the additional value that society places on treatments for severe conditions. The weighting that is applied is calculated for each appraisal based on information on the expected shortfall in life expectancy and quality of life of people with the condition taking into account existing treatment options. NICE has concluded for several appraisals of medicines for advanced cancer that a weighting should be applied based on the severity of the condition. The latest data for appraisals published up to September 2025, show that NICE has recommended 84.8% of treatments for advanced cancers since the severity modifier was introduced compared to 69.1% under its previous methods.

NICE is monitoring the impact of the changes made following the methods review and has committed to considering modular updates to its methods and processes in the future. NICE has also commissioned research to gather further evidence on societal preferences that will inform future methods reviews.

The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). In the financial year 2024/25, the NIHR’s reported spend on cancer research was over £141.6 million through its research programmes and infrastructure, reflecting cancer’s high priority.

The Government is taking measures to boost research into brain tumours. In December 2025, the NIHR announced the pioneering Brain Tumour Research Consortium to accelerate research into new brain tumour treatments. NIHR is investing an initial £13.7 million with significant further funding due to be awarded in 2026.

We also support the Rare Cancers Private Members Bill. This bill aims to incentivise research and investment into treatment by introducing measures to streamline clinical trial recruitment, allow patients to be more easily contacted by researchers, and also mandates a review of orphan drug regulations.

The NIHR continues to welcome funding applications for research into any aspect of human health and care, including brain tumours. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

The final draft, version 1.2, of the Part IX Drug Tariff (Med Tech in the community) Wave 1 categorisation was developed in collaboration with an Expert Reference Group and updated in line with stakeholder feedback over four iterations. The final version was published in October 2025 and can be found on the NHS Business Services Authority Website at the following link:

https://www.nhsbsa.nhs.uk/manufacturers-and-suppliers/drug-tariff-part-ix-information

The Department is currently recruiting Independent Assessment Panels (IAPs) for Wave 1 and has agreed to ask them to review late feedback received from a company on the eye drops category. This is due to take place in February 2026 and will not require further input from industry as it has already been circulated for comment by them.

The Department has also offered to review Drug Tariff Committee feedback regarding the categorisation of medical devices that fall into waves 2 to 4.

The categorisation for waves 2 and 3 is currently being reviewed, and the Department expects to share the updated versions in early 2026 well in advance of the projected launch of waves 2 and 3 in 2027 and 2028 respectively. There are no confirmed plans for reviewing wave 4 at this time. The earliest launch would be in January 2029. All dates are subject to the outcome of the review of wave one.

The Department recognises that the categorisation is not stagnant and may need further amendments as medical devices continue to evolve and the IAPs are stood up. Companies can suggest further amendments when they apply to Part IX of the Drug Tariff or through the Drug Tariff Committee.

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.

Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

The Government plans to publish the modern service framework for severe mental illness in the latter half of 2026.

Engagement on the modern service framework will involve a wide range of stakeholders, such as people with lived experience, clinicians, allied professionals, social workers, the voluntary, community and social enterprise sector, commissioners, and National Health Service Leaders. We have recruited a third Co-Chair for the Modern Service Framework, Jo Lomani, who is a national mental health co-production lead and expert by lived and living experience, to support the implementation of our lived-experience involvement and co-production strategy. This aims to ensure that people who use mental health services stay at the centre of everything we do.

No assessment has been made. NHS England is working with the health innovation networks and has formed the Respiratory Transformation Partnership. Focusing on improving the outcomes of people living with asthma and chronic obstructive pulmonary disease (COPD), this programme seeks to find scalable ways to decrease premature mortality and bed occupancy from respiratory diseases. Initiatives will seek to improve disease recognition, optimise delivery of National Institute for Health and Care Excellence (NICE) approved approaches at neighbourhood level, and uptake of existing and emerging biologic therapies.

The current NHS England severe asthma service specification is being revised by the Specialised Respiratory Clinical Reference Group. The current service specification is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2017/04/specialised-respiratory-services-adult-severe-asthma.pdf

The revised specification will support the management of patients who require further investigation and treatments including biological medicines. The specification will also be updated to reference the most recent clinical guidelines such as the British Thoracic Society, NICE, and the Scottish Intercollegiate Guidelines Network asthma guideline covering diagnosing, monitoring, and managing asthma in adults, young people, and children, and which is expected to improve outcomes for people with asthma and identify early those who require further investigation and treatments including biologic medicines. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng245

While health is predominantly devolved, the Department holds some reserved functions and working together across the United Kingdom on health and social care is ingrained in the values of our National Health Service and social care sector.

The Patient Safety Commissioner’s report covered England-only, however, any response by the Government to the recommendations of the Hughes Report in England will likely have implications for the devolved administrations and their constituents. Engagement between officials across the UK occurs regularly and during an Inter-Ministerial Group meeting on 11 December 2025, the Hughes report was discussed and ministers across the four nations agreed to meet in January 2026 for further engagement.

The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, collects all implant data, and explant data where possible.

Practically, it is always difficult and often impossible to identify a model and product code on an explant. If explanted devices, or patients undergoing explant, cannot be linked to data collected at time of implant, then this often reduces explant data to 'patient, surgeon, location, date'. This in turn makes it impossible to monitor trends in explant/failure.

NHS England is in the process of clarifying and mandating the detail required in the BCIR and other device-related collections.

This will place a greater responsibility on trusts to either identify a device at the point of explant, or to identify the device from internal trust records created during the same patient's implant procedure. This will only be possible if the implant and explant are performed at the same trust. It is then the intention of NHS England to provide the same matching service for implant/explant where the trusts differ.

This solution will, when implemented, give a full, proactive picture of device longevity/risk, for the purposes of research and surveillance, alongside the existing ability to identify patients affected by a device recall notice.

NHS England London Region Specialised Commissioning is currently undertaking a tabletop review of Tier 4 (T4) Personality Disorder inpatient provision within the London footprint. This review is being led by the Nursing and Quality and Mental Health teams and covers all units providing national T4 Personality Disorder inpatient services, which are all located in London.

The review has been initiated in response to a number of quality and environmental concerns identified within the provision. It will also consider how the current T4 Personality Disorder pathway aligns with national mental health policy, including the NHS Long Term Plan, with a particular focus on the strategic shift from inpatient care towards community-based, multidisciplinary models of support.

The review is assessing the effectiveness of the current service model, its clinical distinctiveness, equity of access, and its alignment with national policy objectives.

We’re improving referral processing by introducing a Single Point of Access model, which will provide consistent clinical triage and use digital solutions to streamline processes and reduce duplication. This will ensure patients are directed to the right care quickly.

To support general practitioners and avoid delays, we’re introducing national standards for response times and guidance to underpin clinical triage and advice quality. These will be monitored locally by integrated care boards and reviewed regularly.

The NHS App also already allows people to book and manage their secondary care referrals in 100% of acute trusts, with 89% allowing patients to manage follow up appointments too, with 100% expected in 2026.

No such assessment has been made. We recognise that people are facing unacceptably long waiting times to access mental health support. This is why we are transforming the current mental health system so people can access the right support, at the right time, in the right place.

Building on the 10-Year Health Plan, the NHS Medium Term Planning Framework, published on 24 October 2025, sets targets for integrated care boards in 2026/27 to improve quality and access to mental health services. This includes expanding NHS Talking Therapies and expanding coverage of mental health support teams in schools and colleges.

This builds on the significant progress we’ve made since July 2024 to hire almost 7,000 extra mental health workers. And by spring next year, over 900,000 children and young people will have access to a Mental Health Support team in schools and colleagues.

The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties.

The Government has had discussions with the GMC on this issue. The GMC’s Good Medical Practice states that professionals must act with honesty and integrity and ensure their conduct justifies patient’s trust in them and the public’s trust in the profession. They must also recognise a patient’s right to choose whether to accept their advice. It is up to individual healthcare providers, rather than the GMC, to consider patient requests for care based on sex.

The General Medical Council (GMC) is the regulator of all medical doctors, physician assistants and physician assistants in anaesthesia, still legally known as anaesthesia associates and physician associates, practising in the United Kingdom. The GMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties.

The GMC maintains the official register of registered medical practitioners. Under the Form and Content of the Register Regulations, the GMC records a doctor's gender rather than sex.

The Government has had some discussions with the GMC about this topic. In light of the Supreme Court ruling in the case of For Women Scotland v. The Scottish Ministers regarding the meaning of “sex” in the Equality Act 2010, the GMC is in the process of reviewing its policy position regarding the recording of a doctor’s gender or biological sex on its registers.

Five executive senior managers at NHS England have left since 1 March 2025 and received a payment in lieu of notice. These payments total £553,252.15. 12 executive senior managers at NHS England have left since 1 March 2025 and received a payment in lieu of annual leave. These payments total £124,015.62.

This information is not held centrally as NHS England do not collect supplier payment information on behalf of National Health Service trusts.

This information is not held centrally as NHS England do not collect supplier payment information on behalf of National Health Service trusts.

The Government is clear that patients should expect and receive the highest standard of care throughout the year, including during the busy winter period.

We started earlier and have done more than ever to prepare for winter this year. We continue to monitor the impact of winter pressures on the National Health Service over the winter months, providing additional support to services across the country as needed.

Flu is a recurring pressure that the NHS faces every winter. There is particular risk of severe illness for older people, the very young, pregnant people, and those with certain underlying health conditions. The flu vaccine remains the best form of defense against influenza, particularly for the most vulnerable, and continues to be highly effective at preventing severe disease and hospitalisation.

Decisions about recruitment and resourcing are a matter for individual NHS employers, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.

The Department and the National Infrastructure and Service Transformation Authority (NISTA) will continue to work with the market to further develop the new Public Private Partnership (PPP) model for neighbourhood health centres (NHCs) with further engagement next year. The final design and development of this new PPP model for NHCs will be led by NISTA and co-designed by the Department.

The Department has no plans to publish the NHC PPP Feasibility Programme Business Case. Publication is not standard practice for business cases outside of the Government Major Projects Portfolio.

The Department has no plans to publish the Neighbourhood Health Centre (NHC) Public Private Partnership (PPP) Feasibility Programme Business Case. Publication is not standard practice for business cases outside of the Government’s Major Projects Portfolio. This was a strategic outline business case, the purpose of which was to scope and identify the preferred way forward for a new potential PPP model in line with the HM Treasury five case model.

The Department and the National Infrastructure and Service Transformation Authority (NISTA) will continue to work with the market to further develop the new PPP model for NHCs, with further engagement next year. The final design and development of this new PPP model for NHCs will be led by NISTA and will be co-designed by the Department.

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 refurbishments, 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, delivered through public private partnerships (PPPs) and public capital. 50 NHCs will be completed through the repurposing of the existing estate with public sector funding, and 70 through new builds by 2030. 80% of the new builds will be PPPs, with a further 20% coming from public sector investment.

The Spending Review has seen the Government provide £426 million over four years through the Utilisation and Modernisation Fund, upgrading general practice estates and supporting delivery of 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

As set out in the 10 Year Infrastructure Strategy (the Strategy) and the 10-Year Health Plan, in addition to significant capital investment, the Government would explore the feasibility of using new Public Private Partnership (PPP) models for taxpayer-funded projects in very limited circumstances, where they could represent value for money. This included the potential use of PPPs to deliver Neighbourhood Health Centres (NHCs).

A business case was developed by the Department and supported by National Infrastructure and Service Transformation Authority (NISTA). The business case was considered by ministers and has resulted in the announcement in the Budget published on 26 November 2025.

The Budget builds on the Strategy and the 10-Year Health Plan by confirming that the NHS Neighbourhood Rebuild Programme will deliver new NHCs through upgrading and repurposing existing buildings and building new facilities through a combination of public sector investment and a new model of PPPs.

This new PPP model is being developed by NISTA, and is supported by the Department, and will ensure private sector expertise is harnessed to deliver these assets on time and on budget.

The new model will build on lessons from the past and other models currently in use, and will draw on lessons learnt, including the National Audit Office’s 2025 report on private finance.

To ensure the NHC PPPs are managed transparently and are fiscally sustainable, these partnerships will be budgeted for as if they are on a balance sheet.

Delivering new NHCs through a combination of public investment and PPPs will also allow, for the first time, for evidence to be built and compared between different delivery models.

Each risk in the National Risk Register has a designated Risk Owner, working within the lead Government department which is responsible for designated risk areas.

The Department’s roles and accountabilities in relation to overall risk, and responsibility for managing emergencies, are outlined on the GOV.UK website, at the following link:

https://www.gov.uk/government/organisations/department-of-health-and-social-care/about/our-governance

The Department holds data based on the application process for medical specialty training which allows the identification of unique applicants. This data is part of management information systems summarising information supplied in medical specialty training cycles. Applicants may have chosen to only apply to one specialty programme or may have made multiple applications within the year.

The following table shows the number of unique applicants in rounds one and two of medical specialty training for 2025 and the associated training places available across the United Kingdom:

Source: NHS England Medical Specialty Programme Applications Data.

Round one of the medical specialty application process includes applications to first year specialty training and core training programmes, often referred to as ST1 and CT1 respectively, and some ‘higher’ medical specialty training programmes, usually at year three, often referred to as ST3. Round two is for entry to most ‘higher’ medical specialty training programmes, ST3 or ST4. There will be a limited number of doctors who apply in a year to both rounds one and two.

Information on the number of applications and posts available for individual medical specialty training programmes is published annually by NHS England and can be found at the following link:

https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios

The 10-Year Health Plan set out that 1,000 more specialty training places would be created over the next three years.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would have put in place emergency legislation in the new year which would prioritise United Kingdom and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the National Health Service for a significant period of time for specialty training. This would have applied for current applicants for training posts starting in 2026, and every year after that.

The British Medical Association has rejected the Government's offer and the Government will consider its next steps.

Upon entering the National Health Service after graduation, medical students enter a two-year period of foundation programme placements. The United Kingdom Foundation Programme Office has successfully allocated foundation programme places to all eligible applicants in each of the past three years. These total 10,634 applicants for the 2025 programme, 9,702 for the 2024 programme, and 8,655 in 2023.

Upon successful completion of the foundation programme most doctors choose to apply for speciality training programmes. Competition for speciality training posts has grown in recent years, in part due to the introduction of health and care visas in 2020, as well as the decision to remove the Resident Labour Market Test for doctors in 2020 which has meant that more international medical graduates are applying for speciality training places, increasing the number of candidates for roles.

The table below presents the number of specialist training program applicants and the number of available posts in England by round. The difference between these two numbers is not exactly the number of candidates unable to secure a position as some applicants may not meet the thresholds set for recruitment to specialty training and some may be offered a specialty training post but for a range of reasons do not take up that position.

Source: NHS England Medical Specialty Programme Applications Data.

Round one of the medical specialty application process includes applications to first year specialty training and core training programmes, often referred to as ST1 and CT1 respectively, and some ‘higher’ medical specialty training programmes, usually at year three, often referred to as ST3. Round two is for entry to most ‘higher’ medical specialty training programmes, ST3 or ST4. There will be a limited number of doctors who apply in a year to both rounds one and two.

The 10-Year Health Plan set out that 1,000 more specialty training places would be created over the next three years.

On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee which would have put in place emergency legislation in the new year which would prioritise UK and Republic of Ireland medical graduates for foundation training, and prioritise UK and Republic of Ireland medical graduates and doctors who have worked in the NHS for a significant period of time for specialty training. This would have applied for current applicants for training posts starting in 2026, and every year after that.

The British Medical Association has rejected the Government's offer and the Government will consider its next steps.

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.

The table attached shows the annual budget and the number of full time equivalent (FTE) employees for the UK Health Security Agency, the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, and the National Institute for Health and Care Excellence, each year from 2005/06 to 2024/25. The number of people employed by each arm's-length body has been recorded as FTE (payroll). The annual budget comprises both the Resource Departmental Expenditure Limit and the Capital Departmental Expenditure Limit to give the total Departmental Expenditure Limit budget.