Department of Health and Social Care

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

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

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

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

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

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

The Frimley Integrated Care System (ICS), which covers the Surrey Heath constituency, has implemented several measures to improve maternity and neonatal care. These include the full implementation of the Saving Babies’ Lives care bundle, including an in-house stop smoking service, and the PREM7+ care bundle to improve care for preterm babies.

The Frimley ICS has also launched a new antenatal education offer, is implementing the Maternity Incentive Scheme, a financial incentive that encourages trusts towards actions that improve maternity safety, and is working with the Maternity and Neonatal Voices Partnership to provide birth boxes to improve women’s experience.

At a national level, Baroness Amos is leading a rapid, national, independent investigation into National Health Service maternity and neonatal services to help us to understand the systemic issues behind why so many women, babies, and families experience unacceptable care. The Government is also setting up a National Maternity and Neonatal Taskforce, chaired by my Rt Hon. Friend, the Secretary of State for Health and Social Care. The taskforce will take forward the recommendations of the investigation to develop a new national action plan to drive improvements across maternity and neonatal care.

In November 2024 the National Institute for Health and Care Excellence updated their guideline on endometriosis to make firmer recommendations for healthcare professionals on referral and investigations for women with a suspected diagnosis. This will help women receive a diagnosis and effective treatment faster. This guideline is available at the following link:

https://www.nice.org.uk/guidance/NG73)www.nice.org.uk/guidance/NG73

Additionally, the General Medical Council has introduced the Medical Licensing Assessment to encourage a better understanding of common women’s health problems among all doctors as they start their careers in the United Kingdom. The content for this assessment includes several topics relating to women’s health, including endometriosis. This will encourage a better understanding of common women’s health problems among all doctors as they start their careers in the UK.

Endometriosis is also included in the core curriculum for trainee general practitioners, and for obstetricians and gynaecologists.

An assessment of the adequacy of the availability of information on birth care choices for expectant parents has not been made at a national level.

This information is managed by local trusts and must reflect the facilities that are available locally. Information on birth care choices must also be accompanied by personalised advice from a midwife or obstetrician.

It is expected that care is provided in line with national guidelines, such as guidance issued by the National Institute for Health and Care Excellence (NICE). NICE’s guideline on intrapartum care sets out the standard of intrapartum care, ensuring women and pregnant people receive safe, evidence-based information and support during labour and birth. It emphasises the role of healthcare professionals in supporting informed choice by providing clear information on the full range of birth settings and care options, enabling women to make decisions that reflect their preferences and needs.

The risk of miscarriage is estimated at 15%, and there are approximately 100,000 to 150,000 miscarriages per year in the United Kingdom. However, due to lack of data on the earliest losses, the true figure could be higher at approximately 250,000 a year.

An update to digital record standards on maternity in March 2025 means that the National Health Service is now able to record the pregnancy outcome for any woman, including miscarriage, where they have been in contact with NHS maternity services.

NHS England is in the early stages of a new project to review the Maternity Services Dataset, and we will carefully consider miscarriage information as part of this work.

The Transfer of Undertakings (Protection of Employment) Regulations, or equivalent mechanisms such as the Cabinet Office Statement of Practice, are designed to safeguard employees’ rights during transfers between employers. Employment protections and transition arrangements for NHS England employees will be put in place based on these schemes.

The Department and NHS England are working closely together to identify differences in employment terms and conditions. Where changes are likely to affect staff transferring into the Department, these will be included in formal measures for consultation. This will be communicated once we are in a position to do so.

NHS England has published guidance for National Health Service commissioners on planning service changes, including the decommissioning of services. This includes guidance on clinical evidence and costs.

The guidance also incorporates the Government’s four tests: that service change should have support from commissioners; be based on clinical evidence; demonstrate public and patient engagement; and consider patient choice. This guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/03/planning-assuring-delivering-service-change-v6-1.pd

NHS England has published guidance for National Health Service commissioners on planning service changes, including the decommissioning of services. This includes guidance on clinical evidence and costs.

The guidance also incorporates the Government’s four tests: that service change should have support from commissioners; be based on clinical evidence; demonstrate public and patient engagement; and consider patient choice. This guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/03/planning-assuring-delivering-service-change-v6-1.pd

NHS England has published guidance for National Health Service commissioners on planning service changes, including the decommissioning of services. This includes guidance on clinical evidence and costs.

The guidance also incorporates the Government’s four tests: that service change should have support from commissioners; be based on clinical evidence; demonstrate public and patient engagement; and consider patient choice. This guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2018/03/planning-assuring-delivering-service-change-v6-1.pd

The Department has made no specific assessment. Local National Health Service commissioners are responsible for planning healthcare services that meet the needs of their respective populations. NHS trust interventions will vary across services and in response to a range of local factors.

We are committed to ensuring that the provision of elective surgical hubs and community diagnostic centres (CDCs) is aligned with areas of greatest deprivation and population health need. As a core requirement of the capital business case approval process within NHS England, all proposals have been and continue to be reviewed and assured against the following core principles:

• the CORE20plus5 Framework, a national approach by NHS England to support the reduction of health inequalities at both a national and system level;
• local population health needs; and
• accessibility of care for underserved communities.

This approach ensures equitable access to services, supports the reduction of health inequalities, and promotes improved outcomes for patients across all regions.

NHS England is also working with local National Health Service systems to identify the most appropriate locations for additional investment, including new CDCs. New CDCs should be positioned in a location which addresses local need and health inequalities. Details of future sites will be set out in due course.

The mental health of all National Health Service staff is a high priority, including ambulance staff as responders to emergency incidents.

Significant work is underway to strengthen the quality and consistency of suicide training across the health system. NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management to support the Government’s work to reduce suicide and improve mental health services.  This guidance is available at the following link:

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

At a national level ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction. Additionally, ambulance trusts and the Association of Ambulance Trust Chief Executives have worked closely with NHS England to develop an ambulance sector specific suicide prevention pathway to provide immediate support 24/7 for staff experiencing suicidal ideation.

The mental health of all National Health Service staff is a high priority, including ambulance staff as responders to emergency incidents.

Significant work is underway to strengthen the quality and consistency of suicide training across the health system. NHS England published Staying Safe from Suicide: Best Practice Guidance for Safety Assessment, Formulation and Management to support the Government’s work to reduce suicide and improve mental health services.  This guidance is available at the following link:

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

At a national level ambulance staff have access to the SHOUT helpline for crisis support alongside the Practitioner Health service for more complex mental health wellbeing support, including trauma and addiction. Additionally, ambulance trusts and the Association of Ambulance Trust Chief Executives have worked closely with NHS England to develop an ambulance sector specific suicide prevention pathway to provide immediate support 24/7 for staff experiencing suicidal ideation.

Significant progress has been made towards delivering the ambitions in the 2022 Women’s Health Strategy, for example, improving women and girls’ awareness and access to services and driving research to benefit women’s health.

Renewing the strategy will ensure that we continue this momentum and that it is fully aligned with the 10-Year Health Plan. We will identify and remove enduring barriers to high-quality care, such as decreasing wait times for diagnosis, and ensuring that professionals listen to women and respond to their needs.

We are currently engaging with external partners to inform the renewal of the strategy, bringing together voices from across the Government, NHS England, public health, mental health, women’s health advocacy, and employment policy alongside women with lived experience of women’s health conditions. We are also drawing on the evidence provided by almost 100,000 people in response to the original call for evidence for the 2022 strategy.

The Government recognises that fertility treatment across the National Health Service in England is subject to variation in access. Work continues between the Department and NHS England to better understand NHS-funded fertility services and the effectiveness of these services. This work will take time to develop, and the Department is keen to ensure there will be stakeholder engagement during this process, beginning in the new year.

Funding decisions for health services in England are made by integrated care boards (ICBs) and are based on the clinical needs of their population. We expect ICBs to commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines ensuring equal access to fertility treatment across England.

NICE is currently reviewing the fertility guidelines and will consider whether its current recommendations for access to NHS-funded treatment are still appropriate. A consultation on revised guidelines was published on 10 September and closed on 21 October 2025.

Funding decisions for health services in England are made by integrated care boards, and are based on the clinical needs of their local population. There are no current plans to discuss implementing an increase in the number of funded in-vitro fertilisation cycles with NHS Greater Manchester.

As set out in the 10-Year Health Plan, the Government is committed to making the National Health Service the best place to work, by supporting and retaining our hardworking and dedicated healthcare professionals.

To support this ambition, the Government plans to introduce a new set of standards for modern employment in April 2026. The new standards will reaffirm our commitment to improving retention by tackling the issues that matter to staff including promoting flexible working, improving staff health and wellbeing, and dealing with violence, racism, and sexual harassment in the NHS workplace. They will provide a framework for leaders across the NHS to build a supportive culture that embeds retention.

Targeted retention initiatives for nurses and midwives have also been undertaken by NHS England and led by the Chief Nursing Officer, including: the introduction of a nursing and midwifery retention self-assessment tool; a national preceptorship framework; mentoring schemes; and strengthened advice and support on pensions and flexible retirement options.

Reducing waiting lists is a key part of the Government’s Health Mission, and we are committed to cutting waiting times across all specialities, including gynaecology. We have committed to return to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to treatment, by March 2029.

We are making good progress, as waiting lists have been cut by over 230,000 since the Government came into office, which includes nearly 14,000 fewer patients waiting for gynaecology treatment over the same period.

We have also delivered 5.2 million additional appointments between July 2024 and June 2025, having exceeded our pledge of two million. However, we know there is more to do, and we have confirmed over £6 billion of additional capital investment to expand capacity across diagnostics, electives, and urgent care. This includes expanding the number of surgical hubs, which provide valuable and protected capacity across elective specialities, including gynaecology. As of November 2025, over half of the 123 operational elective surgical hubs in England provide gynaecology services.

The Nursing and Midwifery Council (NMC) is the independent regulator of nurses and midwives in the United Kingdom, and nursing associates in England. The NMC is independent of Government, directly accountable to Parliament and is responsible for operational matters concerning the discharge of its statutory duties. The United Kingdom’s model of healthcare professional regulation is founded on the principle of regulators operating independently from the Government. The Professional Standards Authority for Health and Social Care oversees the bodies that regulate health and care professionals in the UK, which includes the NMC.

As Minister of State for Health (Secondary Care), I monitor the NMC’s performance and meets with the organisation regularly, which includes discussion on the timeliness of the NMC’s fitness to practise processes. In line with the Ministerial Code, details of all ministerial meetings, including those with the NMC, are published quarterly on the GOV.UK website, at the following link:

https://www.gov.uk/government/collections/ministerial-gifts-hospitality-overseas-travel-and-meetings

There have been at least two studies relating to puberty-suppressing hormones and the Tavistock clinic. The Early pubertal suppression in a carefully selected group of adolescents with gender identity disorders study, sponsored by University College London, published its findings in 2021. The Outcomes and Predictors of Outcome for Children and Young People Referred to UK Gender Identity Development Services: A longitudinal Investigation study, funded by the National Institute for Health and Care Research, was due to end in July 2025. We would expect the study findings to be published in a peer reviewed academic journal within 12 months of the completion of the study.

In addition, NHS England, in conjunction with the National Institute for Health and Care Research, is commissioning a data linkage study, which will provide different and separately valuable evidence to both understand the experience and outcomes of former patients of the Gender Identity Development Service and inform future National Health Service gender care. We would similarly expect the study findings to be published.

I refer the Hon. Member to the answer I gave to the Hon. Member for Brigg and Immingham on 1 December 2025, to Question 84585.

The Mid Staffordshire NHS Foundation Trust was set up on 9 June 2010 when Sir Robert Francis was appointed as Chair of the Inquiry. On the same date, this was announced to Parliament by the then Secretary of State for Health, Andrew Lansley.

Sir Francis submitted his final report to then Secretary of State for Health, Jeremy Hunt, on 5 February 2013, which officially closed the public inquiry. The report was published on 6 February 2013.

The Mid Staffordshire NHS Foundation Trust was set up on 9 June 2010 when Sir Robert Francis was appointed as Chair of the Inquiry. On the same date, this was announced to Parliament by the then Secretary of State for Health, Andrew Lansley.

Sir Francis submitted his final report to then Secretary of State for Health, Jeremy Hunt, on 5 February 2013, which officially closed the public inquiry. The report was published on 6 February 2013.

The final draft, version 1.2, of the Part IX Drug Tariff (Med Tech in the community) wave one 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 one 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.

This will not require further input from industry as it has already been circulated for comment by them. The Department has offered to review Drug Tariff Committee feedback regarding the categorisation of medical devices that fall into waves two to four.

The categorisation for waves two and three 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 two and three in 2027 and 2028 respectively. There are no confirmed plans for reviewing wave four 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. Companies can suggest further amendments when they apply to Part IX of the Drug Tariff or through the Drug Tariff Committee.

The final draft, version 1.2, of the Part IX Drug Tariff (Med Tech in the community) wave one 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 one 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.

This will not require further input from industry as it has already been circulated for comment by them. The Department has offered to review Drug Tariff Committee feedback regarding the categorisation of medical devices that fall into waves two to four.

The categorisation for waves two and three 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 two and three in 2027 and 2028 respectively. There are no confirmed plans for reviewing wave four 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. Companies can suggest further amendments when they apply to Part IX of the Drug Tariff or through the Drug Tariff Committee.

From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.

Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.

From November 2024 to October 2025, the NHS Business Service Authority issued 47,058 penalty charge notices (PCNs) to people who claimed a medical exemption but were found to have no exemption in place when checked. Of these, 21,328 were eased, for various reasons including the patient subsequently applying for an exemption successfully. The number of easements in this category cannot be confirmed. Of the 47,058 PCNs issued 3,583 people received multiple PCNs.

Although the Department has made no formal assessment of the effectiveness of issuing PCNs as a deterrent against improper claims, the fact that the vast majority who receive one PCN do not go on to receive another would, in my opinion, suggest a potential deterrent effect.

To ensure an appropriate commercial model is developed for the Health Data Research Service (HDRS), discovery work has been undertaken to gain insight into existing commercial models that might be applicable for the HDRS. This discovery work included engagement with 19 commercial organisations representing users of health data, allowing the development of a robust, up to date, and United Kingdom-wide evidence base. Decisions regarding what commercial model and pricing arrangement is used will be within the remit of the incoming HDRS senior leadership team.

The Quality and Outcomes Framework (QOF) indicator relating to the learning disability register was retired for the 2025/26 contract year. Only people aged 14 years old and over on a general practice (GP) learning disability register are eligible for a learning disability annual health check.

The following table shows the most recent data for those on a learning disability register who have received an annual health check in England for the last three calendar years, up until March 2025, as well as the percentage of patients on a learning disability register who are eligible for an annual health check:

The annual statistics publication of Health and Care of People with Learning Disabilities sets out the key differences in healthcare between people with a learning disability and those without. This includes data on key health issues for people who are recorded on their GP learning disability register, such as uptake of annual health checks. The 2024 to 2025 statistics is scheduled for publication on 4 December 2025.

No formal national assessment has been undertaken, and the Government does not monitor the operation or closure of intentional communities.

We want to ensure that people with a learning disability and autistic people get the support they need in the community and are given a choice about where and with whom they live, including small-scale supported living, and settled accommodation.

Local authorities are best placed to understand and plan for the care needs of their populations, and to develop and build local market capacity. That is why under the Care Act 2014, local authorities are required to shape their local markets, and ensure that people have a range of high-quality, sustainable, and person-centred care and support options available to them, and that they can access the services that best meet their needs.

Any health and social care provider that carries out a regulated activity must register with the Care Quality Commission (CQC), the independent regulator of health and social care in England. The CQC can take action, in line with their Enforcement Policy, if the quality or safety of a service has fallen to unacceptable levels. The CQC is not closing down existing services that provide good care, including services developed as village communities. The CQC does not direct commissioning decisions, which remain the responsibility of local authorities. The CQC’s Enforcement Policy is available on the CQC website, in an online only format.

As a response to the independent review into the CQC’s regulation of Whorlton Hall, the CQC has strengthened its regulatory approach for services for autistic people and people with a learning disability. This included updating the statutory guidance, titled Right support, right care, right culture, which sets out regulatory expectations for any service that currently provides or intends to provide regulated care to autistic people and people with a learning disability.

The Cardiovascular Disease Modern Service Framework (CVD MSF) will help accelerate progress towards the Government’s ambition to reduce premature deaths from heart disease and stroke by 25% within a decade.

The Department has no plans to conduct a formal public consultation as part of the development of the CVD MSF. However, the Department and NHS England are engaging widely with stakeholders to co-produce the CVD MSF, ensuring that experts, people, and communities are at the heart of its development.

The 10-Year Health Plan sets out a transformed vision for elective care by 2035, where the majority of interactions no longer take place in a hospital building, instead happening virtually or via neighbourhood services. Planned care will be more efficient, timely, and effective, and will put control in the hands of patients.

The Elective Reform Plan sets out the productivity and modernisation efforts needed to reach the 92% standard by March 2029. This includes expanding existing community diagnostic centres (CDCs), and building up to five new ones in 2025/26, as well as extending opening hours to 12 hours per day, seven days a week. We will also expand the number of hubs over the next three years. Further details and allocations will be set out in due course.

CDCs are key to delivering on the Government’s ambition to move more planned care from hospitals to the community, reducing pressure on hospitals and delivering more convenient care close to home. Under the Government, CDCs have delivered over 9.4 million tests and scans since July 2024, supporting patients to access vital tests, scans, and checks around their busy working lives.

Dedicated and protected surgical hubs transform the way the National Health Service provides elective care by focusing on providing high volume low complexity surgery, as recommended by the Royal College of Surgeons of England. By separating elective services from urgent and emergency care, hubs improve patient outcomes and reduce hospital pressures. There are currently 123 operational hubs across England, 22 of which have opened since the Government took office.

The 2025 Spending Review confirmed over £6 billion of additional capital investment over five years across new diagnostic, elective, and urgent care capacity. Further details and allocations will be set out in due course.

The Department is aware of the Taskforce for Lung Health’s report calling for a modern service framework for respiratory health, including the impact of respiratory conditions on mortality rates, emergency admissions, inequalities, and productivity.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery. Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia.

The Government will consider other long-term conditions for future waves of modern service frameworks, including respiratory conditions. The criteria for determining other conditions for future modern service frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity.

The Department is aware of the Taskforce for Lung Health’s report calling for a modern service framework for respiratory health, including the impact of respiratory conditions on mortality rates, emergency admissions, inequalities, and productivity.

Modern service frameworks will define an aspirational, long-term outcome goal for a major condition and will then identify the best evidenced interventions and the support for delivery. Early priorities will include cardiovascular disease, severe mental illness, and the first ever service framework for frailty and dementia.

The Government will consider other long-term conditions for future waves of modern service frameworks, including respiratory conditions. The criteria for determining other conditions for future modern service frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity.

The Terminally Ill Adults (End of Life) Bill is, first and foremost, a matter for Parliament. This is a Private Member’s Bill, and we cannot pre‑suppose the outcome of the legislative process.

Irrespective of whether the law changes on assisted dying, we must continue to work towards creating a society where every person who needs it receives high-quality, compassionate palliative care and end of life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the noble Lord to the Written Ministerial Statement HLWS1086, which I gave to the House on 24 November 2025.

The Government is clear that the professions protected in law must be the right ones and that the level of regulatory oversight must be proportionate to the risks to the public.

There are no current plans to extend statutory regulation by the Health and Care Professions Council to clinical technologists or sonographers.

NHS England continues to regularly monitor trust performance.

We are tackling unacceptable ambulance handover delays by introducing a maximum 45-minute standard, supporting the quicker release of ambulances, helping them get back on the road to treat patients. These delays should be recognised as a system wide responsibility and effective collaboration between ambulance services, acute trusts, integrated care boards, and other providers is required.

Nationally, we have seen average handover delays fall to 31 minutes 19 seconds in October compared to 40 minutes 20 seconds in October 2024. This reflects the improvements in Category 2 response times to 32 minutes 37 seconds from 42 minutes 15 seconds over the same time period.

We are also committed to ending corridor care. When Release to Rescue is implemented, ambulance trusts must put in place robust patient protection measures. Patients should only be cared for in temporary escalation spaces when all other options are exhausted, and this must not become standard practice.

Our Urgent and Emergency Care Plan set out steps we are taking to improve accident and emergency waiting times, including the commitment to publish data on the prevalence of corridor care. The data quality is currently being reviewed, and the information will be published shortly.

The Department has had and continues to have regular discussions regarding overseas visitors with NHS England to ensure that the system works as effectively and fairly as possible.

The Government is supportive of the National Health Service working with the charities sector to identify opportunities for philanthropic donations alongside match funding. We are aware of several successful examples of infrastructure projects either part or majority funded through such partnerships, including investment at Great Ormond Street Hospital and Moorfield Eye Hospital.

Ultimately, it is for local NHS organisations and trusts to identify and agree these arrangements with charitable partners.

More broadly, as set out in the 10-Year Health Plan we are implementing several national reforms to the capital regime that should ultimately support the NHS’ ability to work effectively with charitable partners, including on options for securing match funding for projects. These include providing multi-year capital allocations, extending to 10 years of funding certainty for NHS maintenance budgets, and expanding capital flexibilities and autonomy for high-performing providers and integrated care boards. These reforms should enable systems to better plan longer term pipelines of investment, better facilitating and enabling philanthropic and charitable contributions.