Department of Health and Social Care

Our 10-Year Health Plan sets out our vision for a Neighbourhood Health Service, delivering truly integrated, proactive, and personalised care closer to where people live and work. There are substantial benefits to this more integrated approach to health and adult social care. Please see the 10-Year Health Plan Impact Assessment for further information, which is available at the following link:

https://www.gov.uk/government/publications/impact-statement-10-year-health-plan-for-england

The Department is committed to this approach, recognising that an immediate priority for the National Health Service in developing Neighbourhood Health Services is to support individuals with complex needs, especially older people, those living with frailty, and those at the end of life. We expect neighbourhood teams and services to be designed in a way that reflects the specific needs of local populations, including services for elderly people.

No assessment has been made by the Department of the potential impact of National Health Service primary care premises in Thurrock on the recruitment of general practice (GP) doctors. It is the responsibility of the NHS Mid and South Essex Integrated Care Board (ICB) to ensure that the NHS estate in Thurrock is fit for purpose, in order to meet the needs of the local population. GP contractors are responsible for securing, managing, and maintaining suitable premises. The ICB has set up a new joint estates group with Thurrock Council to identify where void space can be used to enhance access to primary, community, and social care facilities.

The ICB has a range of schemes to improve recruitment and retention of GPs, including GP partnership courses, portfolio development scheme, and fellowships for newly qualified GPs. Thurrock has seen an increase in the number of GPs with at least 82 full time equivalent GPs now working in Thurrock, the highest number recorded since March 2016.

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 and will be delivered through public private partnerships and public capital. We are also providing £426 million over four years through the Utilisation and Modernisation Fund, upgrading GP estates, and supporting delivery of 40 to 50 NHCs this Parliament through refurbishment of existing buildings.

Post-graduate medicine general practice specialty trainees consistently report high levels of satisfaction with their overall educational experience, according to the results of the National Education and Training Survey (NETS), 2022 to 2024.

Alongside NETS reporting broadly consistent overall educational experience satisfaction rates across regions, this speciality programme has a low attrition rate nationally.

The Department does not hold data regarding the number and proportion of National Health Service general practice registrations that were for people not born in the United Kingdom.

The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments.

In May 2025, the Government announced the schemes which integrated care boards (ICBs) nominated as eligible to benefit from the £102 million Primary Care Utilisation and Modernisation Fund to deliver upgrades to more than a thousand general practice (GP) surgeries across England this financial year. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care.

Building on this, the Government has committed £426 million of Utilisation and Modernisation funding over the next four years to continue upgrading the GP estate. This funding will also support refurbishing the existing estate to deliver Neighbourhood Health Centres over this Parliament as part of the 10-Year Health Plan commitment.

Operational capital funding allocations have been confirmed for the 2026/27 to 2029/30 period, enabling multi-year planning for ICBs and in turn supporting the delivery of the 10-Year Health Plan’s radical vision for care.

The Government has also allocated £750 million per year for estates safety from 2026/27 to 2029/30, with planning certainty for a further five years, totalling £6.75 billion.

ICBs are responsible for commissioning, which includes planning, securing, and monitoring, GP services within their health systems through delegated responsibility from NHS England. The National Health Service has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area.

As part of inspection activity at GP surgeries, the Care Quality Commission will look at the quality of premises under Regulation 15, covering premises and equipment, although there is no overall rating for this aspect. The intention of this regulation is to make sure that the premises where care and treatment are delivered are clean, suitable for the intended purpose, maintained and, where required, appropriately located, and that the equipment that is used to deliver care and treatment is clean, suitable for the intended purpose, maintained, stored securely, and used properly.

The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments.

In May 2025, the Government announced the schemes which integrated care boards (ICBs) nominated as eligible to benefit from the £102 million Primary Care Utilisation and Modernisation Fund to deliver upgrades to more than a thousand general practice (GP) surgeries across England this financial year. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care.

Building on this, the Government has committed £426 million of Utilisation and Modernisation funding over the next four years to continue upgrading the GP estate. This funding will also support refurbishing the existing estate to deliver Neighbourhood Health Centres over this Parliament as part of the 10-Year Health Plan commitment.

Operational capital funding allocations have been confirmed for the 2026/27 to 2029/30 period, enabling multi-year planning for ICBs and in turn supporting the delivery of the 10-Year Health Plan’s radical vision for care.

The Government has also allocated £750 million per year for estates safety from 2026/27 to 2029/30, with planning certainty for a further five years, totalling £6.75 billion.

ICBs are responsible for commissioning, which includes planning, securing, and monitoring, GP services within their health systems through delegated responsibility from NHS England. The National Health Service has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area.

As part of inspection activity at GP surgeries, the Care Quality Commission will look at the quality of premises under Regulation 15, covering premises and equipment, although there is no overall rating for this aspect. The intention of this regulation is to make sure that the premises where care and treatment are delivered are clean, suitable for the intended purpose, maintained and, where required, appropriately located, and that the equipment that is used to deliver care and treatment is clean, suitable for the intended purpose, maintained, stored securely, and used properly.

The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments.

In May 2025, the Government announced the schemes which integrated care boards (ICBs) nominated as eligible to benefit from the £102 million Primary Care Utilisation and Modernisation Fund to deliver upgrades to more than a thousand general practice (GP) surgeries across England this financial year. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care.

Building on this, the Government has committed £426 million of Utilisation and Modernisation funding over the next four years to continue upgrading the GP estate. This funding will also support refurbishing the existing estate to deliver Neighbourhood Health Centres over this Parliament as part of the 10-Year Health Plan commitment.

Operational capital funding allocations have been confirmed for the 2026/27 to 2029/30 period, enabling multi-year planning for ICBs and in turn supporting the delivery of the 10-Year Health Plan’s radical vision for care.

The Government has also allocated £750 million per year for estates safety from 2026/27 to 2029/30, with planning certainty for a further five years, totalling £6.75 billion.

ICBs are responsible for commissioning, which includes planning, securing, and monitoring, GP services within their health systems through delegated responsibility from NHS England. The National Health Service has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area.

As part of inspection activity at GP surgeries, the Care Quality Commission will look at the quality of premises under Regulation 15, covering premises and equipment, although there is no overall rating for this aspect. The intention of this regulation is to make sure that the premises where care and treatment are delivered are clean, suitable for the intended purpose, maintained and, where required, appropriately located, and that the equipment that is used to deliver care and treatment is clean, suitable for the intended purpose, maintained, stored securely, and used properly.

The Government recognises the importance of strategic, value for money investments in capital projects, such as new facilities, significant upgrades, or other targeted capital investments.

In May 2025, the Government announced the schemes which integrated care boards (ICBs) nominated as eligible to benefit from the £102 million Primary Care Utilisation and Modernisation Fund to deliver upgrades to more than a thousand general practice (GP) surgeries across England this financial year. These schemes will create additional clinical space within existing building footprints to enable practices to see more patients, boost productivity, and improve patient care.

Building on this, the Government has committed £426 million of Utilisation and Modernisation funding over the next four years to continue upgrading the GP estate. This funding will also support refurbishing the existing estate to deliver Neighbourhood Health Centres over this Parliament as part of the 10-Year Health Plan commitment.

Operational capital funding allocations have been confirmed for the 2026/27 to 2029/30 period, enabling multi-year planning for ICBs and in turn supporting the delivery of the 10-Year Health Plan’s radical vision for care.

The Government has also allocated £750 million per year for estates safety from 2026/27 to 2029/30, with planning certainty for a further five years, totalling £6.75 billion.

ICBs are responsible for commissioning, which includes planning, securing, and monitoring, GP services within their health systems through delegated responsibility from NHS England. The National Health Service has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area.

As part of inspection activity at GP surgeries, the Care Quality Commission will look at the quality of premises under Regulation 15, covering premises and equipment, although there is no overall rating for this aspect. The intention of this regulation is to make sure that the premises where care and treatment are delivered are clean, suitable for the intended purpose, maintained and, where required, appropriately located, and that the equipment that is used to deliver care and treatment is clean, suitable for the intended purpose, maintained, stored securely, and used properly.

We have launched wave 1 of the National Neighbourhood Health Implementation Programme (NNHIP) in 43 places across England, including Cornwall and the Isle of Scilly.

This is a large-scale change programme for all partners involved in delivering neighbourhood health, including the National Health Service, local government, social care providers, other statutory and non-statutory organisations and the voluntary sector. There is a strong focus on co-production and working with the people and communities they serve, and taking a ‘test, learn and grow’ approach in line with the wider public sector reform agenda.

We had an overwhelming response to the NNHIP, receiving 141 applications, which is approximately 83% of the number of places in England. Given the large volume of high-quality applications, selecting sites for wave 1 was not an easy task.

Selection was carried out in line with usual NHS England processes, with all applicants assessed against consistent criteria. This includes demonstrating strong integrated working, clear readiness to participate, robust governance and data sharing arrangements, and a focus on areas with the greatest need.

Work is underway to consider the future direction of the NNHIP, and we will share an update on this as soon as we can.

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

Data is available for emergency finished admission episodes where there was a primary diagnosis of 'respiratory conditions’. Data for Stockton West is shown in the table.

Available data on trends in respiratory conditions can be found on the Department of Health And Social Care Fingertips website. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority and integrated care board level. Information for Stockton on Tees is available at the following link:

https://fingertips.phe.org.uk/search/Respiratory

The National Cancer Plan sets out how we will tackle unwarranted variation head on and end the postcode lottery for cancer care.

It will shift healthcare from hospitals to the community and ensure that all cancer patients, regardless of where they live, have access to high-quality, specialist cancer services.

We will redesign cancer services around people’s lives, not just around hospitals, recognising that more people are living for longer with and beyond cancer and need ongoing, coordinated support. The plan provides the blueprint for England to become a world leader in cancer survival once again and improve the quality of life for those living with cancer in England.

The following table shows the nominal and real terms funding provided through the Community Pharmacy Contractual Framework each year since 2015/16:

In 2025/26, the funding for the core community pharmacy contractual framework was increased to £3.1 billion. This represented the largest uplift in funding of any part of the National Health Service at the time, over 19% across 2024/25 and 2025/26. Additional funding was also made available, for example, for pharmacies delivering Pharmacy First consultations and flu and COVID-19 vaccinations.

Foundation trainee pharmacists who have graduated against the 2021 standards for the initial education and training of pharmacists are required to have a Designated Prescribing Practitioner (DPP), a healthcare professional with independent prescribing rights, such as a doctor, pharmacist, or nurse, to support the supervision and assessment of prescribing activities during their foundation year.

Under the Foundation Trainee Pharmacists National Recruitment Scheme, training providers are required to ensure that trainees have access to a DPP and to submit DPP details to NHS England once the trainee pharmacist is in post.

Of the 2,894 graduates in England who began foundation pharmacist training in 2025/26, 2,417 trained against the 2021 standards and therefore require a DPP. As of February 2026, 2,013 of these trainees, approximately 83%, had submitted details of an assigned DPP to NHS England.

By training window, 1,814 of 2,119 summer starters, or 85.6%, and 199 of 318 autumn starters, or 62.5%, had submitted DPP details. Autumn starters typically undertake prescribing later in the training year, and some may not yet have been required to submit DPP information. NHS England continues to monitor this.

There are no current plans to prohibit National Health Service employees in England who undertake strike action from being paid for work by other NHS bodies on strike days.

NHS staff who are on strike are not prevented by law from working for non-NHS bodies or other NHS organisations, including NHS trusts, on days of industrial action, as long as they are not provided by an employment business to cover the work of striking workers. Before the British Medical Assocation Resident Doctors Committee (BMA RDC) strike action in July 2025, NHS England set out in guidance that resident doctors who have chosen to take industrial action should not undertake a locum or bank shift elsewhere during the period of action. This guidance is available at the following link:

https://www.hee.nhs.uk/sites/default/files/documents/Industrial%20action%20FAQs%20-%20training%20progression.pdf

During the BMA RDC strike action in December 2025, NHS England issued additional communications to trusts to reaffirm the existing guidance.

NHS staff should consider the guidance published by the relevant professional bodies before undertaking additional work during strike days. The Department continues to monitor the impact of industrial action on NHS services and staffing arrangements.

I refer the hon. Member to the answer I gave on 24 February 2026 to Question 84239.

Data reported in the Department’s Annual Report and Accounts for 2024/25 is limited to providing high-level data on the total number and cost of exit payments, including non-contractual severance payments. This data is not broken down to identify the name or type of specific organisations or payment types. The data provided in the Department’s accounts use consolidated data from NHS England.

NHS England has confirmed that during 2024/25, there were 33 exit payment cases disclosed by integrated care boards which were of a value of £150,001 or more. This means that an exit package might be agreed, approved, and accrued in one financial year, and so disclosed in that year, but the actual payment may, in some cases, fall into the next financial year. NHS England does not hold information to identify where this is the case.

The National Cancer Plan will redesign cancer services around people’s lives, not just around hospitals, recognising that more people are living for longer with and beyond cancer and need ongoing, coordinated support. To achieve this aim, the plan committed to the development of new standards for both prehabilitation and rehabilitation through cancer manuals by 2028.

Through the National Cancer Plan’s implementation, more cancer care and support will be delivered closer to home, including a universal digital-first prehabilitation offer, expanded supportive oncology, greater use of virtual monitoring, and growing opportunities for treatment and follow-up in community settings where safe and appropriate.

For patients who have more extensive needs and who will require more support to live well, the National Health Service will deliver an enhanced level of care during and after treatment, known as supportive oncology. This will include enhanced rehabilitation, psychological support, and preventative interventions, such as physical activity and smoking cessation. Additionally, it will include acute oncology, support for severe and sometimes sudden symptoms, that means people can get rapid access to the right care in their home or community where appropriate.

The National Cancer Plan will redesign cancer services around people’s lives, not just around hospitals, recognising that more people are living for longer with and beyond cancer and need ongoing, coordinated support. To achieve this aim, the plan committed to the development of new standards for both prehabilitation and rehabilitation through cancer manuals by 2028.

Through the National Cancer Plan’s implementation, more cancer care and support will be delivered closer to home, including a universal digital-first prehabilitation offer, expanded supportive oncology, greater use of virtual monitoring, and growing opportunities for treatment and follow-up in community settings where safe and appropriate.

For patients who have more extensive needs and who will require more support to live well, the National Health Service will deliver an enhanced level of care during and after treatment, known as supportive oncology. This will include enhanced rehabilitation, psychological support, and preventative interventions, such as physical activity and smoking cessation. Additionally, it will include acute oncology, support for severe and sometimes sudden symptoms, that means people can get rapid access to the right care in their home or community where appropriate.

I remain deeply concerned by the state of maternity care we inherited in the NHS.

The Secretary of State announced 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, led by Baroness Amos is looking into the maternity and neonatal system nationally and will bring together the findings of past reviews into one clear national set of recommendations, and will publish its final report and recommendations in the Spring 2026.

The government is also setting up a National Maternity and Neonatal Taskforce, chaired by the Secretary of State for Health and Social Care. The Taskforce will address the recommendations of the Investigation by developing a new national action plan to drive improvements across maternity and neonatal care.

We are not waiting for the investigation to report. We are taking immediate actions to boost accountability and safety as part of the government’s mission to build an NHS fit for the future. This includes a new early warning system to better identify safety concerns, implementing a new programme to reduce brain injuries in childbirth, rolling out a programme to all trusts to tackle discrimination and racism, investing over £149 million into the maternity estate, and new best practice standards in maternal mortality.

As part of NHS England’s assessment process, eligible National Health Service trusts and foundation trusts which apply for the Advanced Foundation Trust Programme will need to demonstrate effective mechanisms to engage meaningfully with patients, staff, and communities, and that involvement influences decisions.

The removal of councils of governors from NHS foundation trusts forms part of the wider aim of the 10-Year Health Plan to ensure that hospitals put patient experiences and outcomes at the heart of their decision-making. While governors have provided helpful advice and oversight for some foundation trusts, we now need to move to a more dynamic model of drawing on patient, staff, and stakeholder insight.

The Department invests £1.6 billion each year on research through the National Institute for Health and Care Research (NIHR). Cancer is a major area of NIHR spending at £141.6 million in 2024/25, reflecting its high priority.

NIHR research infrastructure has national coverage for the whole of England. Our infrastructure schemes aim to build research capacity and capability across all geographies, settings, and disease areas, including understanding disease biology, patient access to novel treatments, and dedicated spaces for medicine studies.

In addition, through the NIHR Research Delivery Network (RDN), the NIHR supports 100% of National Health Service trusts in England to deliver research, operating across 12 regions throughout the country. The RDN also provides health research delivery investment that better enables trial access across wider care settings, including primary care, community-based, and residential research delivery organisations. In 2024/25 the RDN supported over 1,200 cancer studies, including the recruitment of almost 100,000 patients to cancer studies.

The NIHR continues to encourage and welcome applications for research into any aspect of human health and care, including all cancer types.

NHS Resolution will not hold records of complaints as they will be managed locally by the service provider.

Where an individual National Health Service trust is a member or beneficiary of NHS Resolution’s indemnity schemes, NHS Resolution will keep records of claims or cases resolved through mediation or settlement.

As such, whether NHS Resolution holds relevant records will first be dependent on the individual trusts that host specialist gender services participating in these schemes.

The Trust’s evaluation found that revised opening hours at Crawley Hospital Urgent Treatment Centre reduced the average time patients spend in the UTC by 17 minutes, with no significant impact on nearby emergency departments. Decisions on local service configuration are the responsibility of NHS commissioners. The Government has committed £250 million in the UEC Plan 25/26 to expand co-located urgent treatment centres alongside same day emergency care.

Employers in the health system are responsible for ensuring that their staff are trained to the required standards to deliver appropriate treatment for patients.

Care providers are also required to ensure staff receive the support, training, professional development, supervision, and appraisal necessary to carry out their duties safely and competently.

To support providers to do so, the Department provides reimbursement towards the cost of training and qualifications through the Adult Social Care Learning and Support Scheme, backed by up to £12 million in funding this financial year.

NHS England’s Clinical Priorities Advisory Group (CPAG) meets monthly to consider policy and service specifications that are categorised as cost saving or cost neutral.

CPAG prioritisation meetings are held annually. The next prioritisation meeting is planned for spring 2026.

Reducing waiting lists, including for endometriosis and other gynaecological conditions, is a key part of the Government’s Health Mission. We are committed to returning to the National Health Service constitutional standard that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment by March 2029. As of the end of December 2025, the gynaecology waiting list stands at 577,232, with 57.3% of patient pathways waiting less than 18 weeks, an improvement of 1.9% since December 2024.

We know there is more to do to improve access to endometriosis care and waiting times against the 18-week standard. We are expanding the number of dedicated and protected surgical hubs, of which gynaecology procedures are a key offering, and commissioning research focussed on endometriosis diagnosis, treatment, and pain. We are also introducing an “online hospital”, NHS Online, which from 2027 will provide additional appointments to cut waiting times for certain pathways. This includes people who are experiencing menstrual problems, a potential sign of endometriosis, who will be given the choice of receiving at least some of their specialist care from the convenience of their own home. Across all specialities, NHS Online will deliver the equivalent of up to 8.5 million appointments and assessments in its first three years, four times more than an average trust.

We are improving the standards of care for women with severe endometriosis by ensuring specialist endometriosis services have access to the most up-to-date evidence and advice on diagnosis and treatment. In 2025, the National Institute for Health and Care Excellence approved two new pills to treat endometriosis, Relugolix and Linzagolix. Both are estimated to help approximately 1,000 women with severe endometriosis.

The next Clinical Priorities Advisory Group (CPAG) prioritisation meeting is planned for spring 2026, where policies that are ready and require investment decisions to be taken will be considered. It is expected up to 20 such policies will be considered at the next meeting.

CPAG also continues to meet monthly to consider policy and service specifications that are categorised as cost saving or cost neutral.

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

Integrated care boards (ICBs) are responsible for the commissioning of elective care services, based on the needs of their population.

The NHS Payment Scheme is the set of rules, prices, and guidance that determine how providers of National Health Service-funded healthcare are paid for the services they provide. It is designed to ensure that funding flows fairly and efficiently across the healthcare system. Under the NHS Payment Scheme 2025/26, NHS trusts should not be paid under a block contract basis for elective care. NHS trusts should be paid on the basis of the elective care they deliver.

The only exception is where the value of patient activity between a commissioner and an NHS trust is less than £1.5 million, and in these circumstances the trust is paid a fixed amount for all the activity that they deliver for that commissioner, including both elective and non-elective, to minimise the number of low value transactions between NHS organisations.

NHS England expects each ICB and provider to meet the requirements of the 2025/26 Planning Guidance, including delivering the necessary elective recovery targets. Where systems and providers are failing to meet their plans, NHS England will work with them to ensure appropriate mitigations are in place. This can include escalation into the national tiering programme, and the provision of improvement support. The National Oversight Framework describes how NHS England assesses ICBs and NHS providers, ensuring public accountability for performance. These processes are the same for all providers and systems, regardless of the commissioning arrangements in place.

Details of the 2025/26 NHS Payment Scheme are published at the following link:

https://www.england.nhs.uk/long-read/25-26-nhs-payment-scheme/

The Government will consider long-term conditions for future waves of modern service frameworks (MSFs), including respiratory conditions. The criteria for determining other conditions for future MSFs will be based on where there is potential for rapid and significant improvements in quality of care and productivity. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

Data is available for emergency Finished Admission Episodes (FAEs) where there was a primary diagnosis of 'respiratory conditions’. The following table shows the number of FAEs where there was a primary diagnosis of 'respiratory conditions’ for Bexhill and Battle and for England, for activity in English National Health Service hospitals and English NHS commissioned activity in the independent sector, for 2024/25 and provisionally 2025/26:

Source: Hospital Episode Statistics, NHS England.

Available data on trends in respiratory conditions can be found on the Department’s fingertips dataset. Data is not available by parliamentary constituency. Data is available at regional, county, unitary authority, and integrated care board level. Information for East Sussex can be found at the following link:

https://fingertips.phe.org.uk/search/Respiratory#page/1/gid/1/pat/15/ati/502/are/E10000011/iid/40701/age/163/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1

The Government has committed to delivering three big shifts that our NHS needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to improving respiratory health in all parts of the country.

Through our community diagnostic centres we are building capacity for respiratory testing and enabling people to get diagnosed closer to home. 101 community diagnostic centres across the country now offer out of hours services, 12 hours a day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives. This is alongside action being taken to expand capacity and improve the quality of pulmonary rehabilitation services to support patients living with respiratory conditions.

No formal assessment of the impact of block contract arrangements on National Health Service productivity has been made. However, the 10‑Year Health Plan sets out the Government’s intention to move away from block contracts, paid irrespective of how many patients are seen or the quality of care, and to realign funding with activity and performance.

Under these reforms, payment for poor‑quality care will be withheld, high‑quality care will attract additional reward, and new incentives will be introduced for the most effective NHS leaders, clinicians, and teams. These changes are designed to support clearer accountability, improve productivity over time, and ensure that NHS resources are targeted where they deliver the greatest value for patients.

No such assessment has been made. The Department for Education provides the primary student support package for domestic dental students in higher education through Student Finance England (SFE).

From year five of an undergraduate and year two of a graduate-entry course, these students can access the NHS Bursary. For this academic year the Government increased the NHS Bursary tuition fee contributions, maintenance grants, and all allowances by 3.1%, in line with increases to SFE support.

This is the second academic year the Government has increased support for medical and dental students through the NHS Bursary. Prior to this the maintenance grants had not been uplifted since 2015. We understand that these uplifts do not go far enough to make up for the historical lack of uplift. However, this is a step in the right direction, and we continue to keep funding for dental students under review.

To improve referral rates for pulmonary rehabilitation (PR), NHS England has issued detailed guidance to integrated care boards on strengthening PR workforce capacity, ensuring safe staffing levels, and developing accessible service models to reduce health inequalities. Further information is available at the following link:

https://www.england.nhs.uk/long-read/pulmonary-rehabilitation-workforce/

NHS England has additionally recently published guidance on chronic obstructive pulmonary disease (COPD) biologics that reiterates the need for PR to be taken into account when planning care for people with COPD. Further information is available at the following link:

https://www.england.nhs.uk/long-read/business-case-guidance-copd-biologics/

The 10-Year Health Plan committed to the roll out of Staff Treatment Hubs, to provide a high-quality wellbeing and occupational health service for all National Health Service staff. Work is underway to develop implementation and operational plans for the Staff Treatments Hubs. This will determine factors such as location, budgets, timeframes, capacity, and processes for monitoring progress and performance.

Everyone working in the National Health Service has a fundamental right to be safe at work. Violence rates in mental health settings are lower than the national average. Individual employers put in place a robust range of measures, including, security, training, and emotional support for staff that are affected by violence.

Everyone working in the National Health Service has a fundamental right to be safe at work. There is a zero-tolerance approach to violence in the workplace.

Individual employers are responsible for the health and safety of their staff, and they put in place measures, including, security, training, and emotional support for staff affected by violence.

Existing measures will be strengthened by the introduction of a new set of staff standards, as detailed in the 10-Year Health Plan.

Pulmonary rehabilitation (PR) is a clinically proven intervention that improves outcomes and reduces hospital admissions for people with chronic respiratory conditions. Health Education England reported in 2022 that increasing access to PR for people with lung conditions could save NHS England £69 million every year and see a reduction of 150,924 general practice appointments, and 26,633 fewer hospital admissions per year. Further information is available at the following link:

https://www.hee.nhs.uk/sites/default/files/documents/Respiratory%20Disease%20Report.pdf

NHS England has additionally recently published guidance on chronic obstructive pulmonary disease (COPD) biologics that reiterates the need for PR to be taken into account when planning care for people with COPD. This provides cost and health benefit information for integrated care boards to help create business cases for setting up COPD services. Further information is available at the following link:

https://www.england.nhs.uk/long-read/business-case-guidance-copd-biologics/

NHS England holds a quarterly PR steering group that provides direction, challenge and support for decision-making, and monitors progress against set metrics as reported through the national respiratory audit programme. Further information is available at the following link:

https://www.nrap.org.uk/NRAP/welcome.nsf/0/B2AB84D12BC2C43280258CF20030EC2C/$file/NRAP_State_of_the_Nation_Catching_our_breath_2025.pdf

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 ring-fenced funding for maternity services has been removed, the same level of funding is being delivered. This is to allow local healthcare system leaders more autonomy to meet the needs of their local population. The Government will continue to monitor integrated care board investment in maternity services.

We are committed to returning to the National Health Service constitutional standard that 92% of patients are treated within 18 weeks of referral to consultant-led care, including gynaecology, by March 2029. As of the end of December 2025, the waiting list for gynaecology services stood at 577,232. Of these patient pathways, 57.3% were waiting within 18 weeks. This an improvement from December 2024 where the waiting list for gynaecology services was 586,202, 55.4% of which were within 18 weeks.

There is clearly more progress to be made. The Government will continue to develop innovative models of care in the community, including piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding, and increasing the relative funding available to incentivise providers to take on more gynaecology procedures.

We are committed to expanding the number of surgical hubs, which provide valuable and protected capacity across elective specialities, including gynaecology. Currently, over half of the 125 operational elective surgical hubs in England provide gynaecology services.

We are also introducing an “online hospital”, NHS Online, which aims to provide additional appointments to cut waiting times. From 2027, people on certain pathways, including severe menopause symptoms and menstrual problems that may be a sign of endometriosis or fibroids, will have the choice of being referred to NHS Online to receive at least some of the specialist care they need from the convenience of their home.

Healthwatch has played an important role in supporting patient involvement in the National Health Service, and in our 10-Year Health Plan we recognise the valuable work they have done to gather patient feedback and influence the debate around local service delivery.

Healthwatch was one of six organisations covered by Dr Penny Dash’s review of patient safety across the health and care landscape. The review found that there are too many organisations doing this type of work, which can create confusion for patients and risks limiting impact given their distance from service providers and commissioners.

In response, we have committed in our 10-Year Health Plan to bring Healthwatch England’s strategic functions ‘in house’ within a reformed Department, giving patients a stronger national voice through the creation of a new National Director of Patient Experience. At the same time, the statutory functions of Local Healthwatch will be brought together with the involvement and engagement responsibilities of integrated care boards, ensuring that patient insight is more directly connected to local decision-making and service improvement.

Across the Department and NHS England, £1,067,157.34 has been spent directly on Part IX of the Drug Tariff, including VAT where applicable. This does not include Department and NHS England staff time. This covers the period 2024/25, and 2025/26. This includes planned spend up until the end of the 2025/2026 financial year.

For the MedTech Commercial Strategy, across the Department and NHS England, planned direct spend up until the end of the 2025/26 financial year is £120,000. This does not include Department and NHS England staff time and includes VAT.