Department of Health and Social Care

The Government is advised on all screening matters by the UK National Screening Committee (UK NSC), an independent scientific advisory committee which is made up of leading medical and screening experts. Where the committee is confident that there is robust evidence that demonstrates that to offer screening provides more good than harm, they recommend a screening programme.

The UK NSC made a recommendation not to screen children for lead poisoning in 2018. This is because:

- the number of children affected in the United Kingdom is currently not known;

- the test was not reliable enough; and

- treatments in children with mild symptoms have not been proven and may also be harmful.

In 2024 a proposal was submitted to the UK NSC via its open call, to review the decision made in 2018 for screening children for lead poisoning. The UK NSC is planning to undertake an evidence map, which is the first step in the evidence review process.

The UK Health Security Agency (UKHSA) advises that exposure to lead should be as low as reasonably practicable. The UKHSA support partners in identifying the pathway and source of lead and advises on appropriate public health interventions to aid in reducing exposure. Interventions include interruption of lead exposure pathways by source identification and remediation or abatement, behavioural interventions, and consideration of whether others may be at risk of exposure. The UKHSA is also involved in raising awareness as many healthcare professionals are unaware that lead still poses a risk in the UK and elsewhere.

The remit of the UKHSA in relation to lead contamination is advisory and does not extend to undertaking any remedial measures.

The commitment to fund travel costs of up to £10 million per year to support children and young people with cancer is a key priority for the National Cancer Plan.

The Department is currently working with its partners to define the scope and parameters of the scheme and further detail will be announced in due course.

The Department recognises that survival rates are too low for rarer cancers, such as brain cancers, and that there are currently limited treatment options available for people who have been diagnosed with brain tumours.

The National Cancer Plan (NCP) has set comprehensive measures to drive up cancer survival rates and improve outcomes for all cancer patients, including those with rarer and less common cancers such as glioblastoma. These measures include speeding up diagnosis and treatment to meet the cancer standards, ensuring patients have access to the latest treatments and technology though innovative projects, expanding access to genomic testing to diagnose and support more personalised treatment approaches, and reducing variation in access to cancer care so patients receive timely diagnosis and treatment from wherever they live.

Patients with rare cancers will also benefit from a move to specialist multi-disciplinary teams, that cover multiple providers. This will allow them to benefit from the input of specialist centres and so access to the best evidence-based care.

To meet its obligations for rare cancers, including brain tumours, the Government will appoint a new national clinical lead for rare cancers. This national clinical lead will have a clear mandate to speak up for rare cancers, and to provide clinical advice and support for the delivery of the actions in the plan.

The NCP further included a commitment to reduce the number of rare cancers, including brain tumours, being diagnosed in emergency settings. Brain cancers cannot be staged like other cancers and are subsequently not included in current early diagnosis measures. The National Health Service in England will improve on this system by regularly publishing early diagnosis data for brain tumours, incentivising systems to focus on these cancers.

The successful implementation of this plan will mean that three in every four people diagnosed in 2035 will be cancer-free or living well with cancer after five years. That translates to 320,000 more lives saved over the course of this plan, and the fastest rate of improvement this century.

Finally, the Government also backed the launch of RECURRENT‑GB, a new nationwide trial exploring whether surgery can improve the quality of life for patients when glioblastoma comes back after treatment commenced and is backed by £1.98 million of National Institute of Health and Research funding.

The Department recognises that survival rates are too low for rarer cancers, such as brain cancers, and that there are currently limited treatment options available for people who have been diagnosed with brain tumours.

The National Cancer Plan (NCP) has set comprehensive measures to drive up cancer survival rates and improve outcomes for all cancer patients, including those with rarer and less common cancers such as glioblastoma. These measures include speeding up diagnosis and treatment to meet the cancer standards, ensuring patients have access to the latest treatments and technology though innovative projects, expanding access to genomic testing to diagnose and support more personalised treatment approaches, and reducing variation in access to cancer care so patients receive timely diagnosis and treatment from wherever they live.

Patients with rare cancers will also benefit from a move to specialist multi-disciplinary teams, that cover multiple providers. This will allow them to benefit from the input of specialist centres and so access to the best evidence-based care.

To meet its obligations for rare cancers, including brain tumours, the Government will appoint a new national clinical lead for rare cancers. This national clinical lead will have a clear mandate to speak up for rare cancers, and to provide clinical advice and support for the delivery of the actions in the plan.

The NCP further included a commitment to reduce the number of rare cancers, including brain tumours, being diagnosed in emergency settings. Brain cancers cannot be staged like other cancers and are subsequently not included in current early diagnosis measures. The National Health Service in England will improve on this system by regularly publishing early diagnosis data for brain tumours, incentivising systems to focus on these cancers.

The successful implementation of this plan will mean that three in every four people diagnosed in 2035 will be cancer-free or living well with cancer after five years. That translates to 320,000 more lives saved over the course of this plan, and the fastest rate of improvement this century.

Finally, the Government also backed the launch of RECURRENT‑GB, a new nationwide trial exploring whether surgery can improve the quality of life for patients when glioblastoma comes back after treatment commenced and is backed by £1.98 million of National Institute of Health and Research funding.

The National Cancer Plan is a key part of our work to build a National Health Service fit for the future, and it sets out how we will make England a world leader in cancer outcomes. Prostate cancer is the most common cancer in men, and the Government is taking this issue seriously.

However, there are currently no clinically validated and reliable at-home prostate specific antigen (PSA) tests that are suitable for use in the NHS by asymptomatic men in any risk category.

In addition, the UK National Screening Committee (UK NSC), which advises ministers on all screening matters, recently closed a 12-week public consultation on a draft recommendation to offer targeted screening for prostate cancer in men with variants of BRCA1 and BRCA2 genes, every two years from the age of 45 to 61 years old, but advising against screening for other high risk groups due to either an absence of evidence, or evidence that shows that doing so would do more harm than good.

We expect the UK NSC to make a final recommendation soon. My Rt Hon. Friend, the Secretary of State for Health and Social Care, will then consider the advice, make a decision, and determine the next steps. This includes access to PSA testing.

The cost-effectiveness methodology used by the Joint Committee on Vaccination and Immunisation (JCVI) ensures that decisions are objective, consistent, and based on high-quality data on health benefits and costs. This approach is not understood to disadvantage vaccinations and immunisations as a form of prevention when compared with treatments, therapeutic health measures, or other forms of prevention.

This is because, similar to the JCVI, the National Institute for Health and Care Excellence also applies a health‑sector perspective when appraising preventative and treatment interventions. Beyond vaccines, many other health interventions can generate wider societal or economic benefits, and so applying an appraisal approach across the health system which is consistently focused on health benefits does not uniquely disadvantage vaccinations or immunisations.

We have one of the most comprehensive vaccination programmes in the world. Our approach to evaluating vaccination programmes is informed by expert recommendations and advice from the Joint Committee on Vaccination and Immunisation (JCVI). Working closely with the UK Health Security Agency‑based JCVI secretariat, the Department ensures that the cost-effectiveness methodology for assessing vaccination programmes continues to enable the committee to advise on programmes that deliver the greatest health benefit to the greatest number of people.

The Department maintains oversight of this methodology on an ongoing basis, with particular focus when the range of available evidence and underlying evidence landscape changes over time. Those changes may arise from time to time at irregular intervals, and so it is unlikely to be helpful to review the methodology at fixed and regular intervals.

Improving outcomes for rare cancer patients is a priority for the National Cancer Plan. The National Disease Registration Service (NDRS) in NHS England, as the national cancer registry, collects diagnosis, treatment, and outcome data on cancer patients in England. All these cancer sites, such as brain, liver, lung, stomach, pancreatic, and oesophageal, are already included in NDRS’ Get Data Out (GDO) programme. Performance data is not included in GDO but incidence, treatment, survival, and routes to diagnosis statistics are available for the clinically meaningful groups of cancers included.

Each year, our National Health Service screening programmes invite over 15 million people for screening, with over 10 million taking up the invitation. In total, this saves approximately 10,000 lives every year and enables many others to make better informed decisions around their health.

The Government is advised on all screening matters by the UK National Screening Committee (UK NSC), an independent scientific advisory committee which is made up of leading medical and screening experts. Where the committee is confident that there is robust evidence that to offer screening provides more good than harm, they recommend a screening programme.

In 2016, the committee reviewed the evidence for screening pregnant women for toxoplasmosis and did not recommend screening because:

- the screening test would incorrectly show that toxoplasmosis is present in many women;

- it is not known if the current treatment, antibiotics, would stop the infection being passed to the baby or reduce the severity of the infection; and

- there is not enough information about how many people might get the infection in the United Kingdom.

The UK NSC will review the evidence again within their usual work cycle.

Regarding screening children and other adults for toxoplasmosis, the UK NSC has never been asked to consider screening for these groups of people.

Any person or organisation can submit a proposal for a new screening topic during the UK NSC’s three-month open call process which will next run from 1 July 2026 to 30 September 2026.

The following table shows the full time equivalent (FTE) number of doctors working across general practice, primary care networks, and hospital and community health services in England, and the proportion of these who were fully qualified general practitioners, consultants, or specialty and associate specialist doctors:

Sources: NHS Workforce Statistics, General Practice Workforce Statistics, and Primary Care Network Workforce Statistics, all published by NHS England.

Decisions on recruitment are a matter for individual National Health Service trusts which manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.

The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan.

The 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it. We are working through how the plan will articulate the changes for different professional groups.

In 2025, NHS England’s Getting It Right First Time programme published new and revised cardiology pathways to support evidence-based, including National Institute for Health and Care Excellence guidance, efficient, and consistent care across primary and secondary settings, including for aortic stenosis for patients with severe symptomatic heart valve disease.

NHS England has established an Expert Advisory Group on Heart Valve Disease with the aim of ensuring excellence in care whilst exploring ways to improve heart valve disease management nationwide.

NHS England’s published enforcement guidance sets out how it uses its enforcement powers and the regulatory and statutory processes in the event of enforcement action. The guidance states that directions under section 14Z61 should only be issued as a last resort where voluntary action has not proved possible and NHS England must be satisfied that the integrated care board is failing or has failed to discharge its functions, or that there is a significant risk it will do so.

In 2025/26, we are investing over £149 million through the Estates Safety Fund to tackle the poorest quality infrastructure across the National Health Service maternity and neonatal estates. This will deliver vital safety improvements, enhance patient and staff environments, and support NHS productivity, enabling better care for mothers and their newborns. A further £25 million will support trusts to tackle the causes of maternal death, enhance maternity bereavement facilities, and improve triage services.

In addition, we are backing the NHS with over £4 billion in operational capital in 2025/26, with a further £16.9 billion over the following four years. NHS organisations will manage their operational capital allocations locally and can assign funding to maternity and neonatal infrastructure if this is a local priority.

Toxoplasmosis is not a notifiable disease in England. However, since April 2025, laboratories are required to notify the detection of toxoplasma associated with congenital toxoplasmosis under amendments to the Health Protection (Notification) Regulations. Current national toxoplasmosis surveillance is limited to samples referred to the Toxoplasma Reference Unit (TRU). Toxoplasmosis surveillance data is published annually by the UK Health Security Agency (UKHSA). Data for ocular toxoplasmosis is not routinely collected by UKHSA.

Data is not held in the format requested as it is reported by broader age groups, and this is shown below, and can also be found in the annual report available online. The data below will be an underestimate of national figures due to toxoplasmosis not being a notifiable disease, and the use of TRU reported cases only.

The following table shows the number of laboratory confirmed cases of toxoplasmosis in England by age group and sex, for 2024:

Work is currently ongoing within UKHSA to review and update toxoplasmosis surveillance processes in England.

The Government is committed to ensuring joined up health and care services. While the Independent Commission will inform the long-term direction of a national care service, the Government is already progressing reforms to strengthen the join up between services, so people experience more integrated and person-centred care.

We are developing Neighbourhood Health Services, which will allow more integrated working within the National Health Service, as well as between the NHS, local government, and a wide range of public services, including the voluntary, community, and social enterprise sector. The National Care Service and the Neighbourhood Health Service will play a critical role in helping people stay independent for longer, minimising the time that they need to spend in hospital or in long-term residential care.

Alongside this, we are improving national data and digital infrastructure, including driving the adoption of digital and social care records so people get the right care quicker, without needing to repeat their care needs or medical history.

The Human Fertilisation and Embryology Authority (HFEA) does not hold information on the reasons eggs were frozen. Data from 2015 to 2023 is available on the number of patients undergoing egg freezing cycles per year, without the reasons the eggs were frozen, and are as follows: 1,020 in 2015; 1,165 in 2016; 1,365 in 2017; 1,755 in 2018; 2,130 in 2019; 2,030 in 2020; 3,400 in 2021; 3,910 in 2022; and 5,515 in 2023. This information is from the HFEA Register.

The Government has committed to ending the practice of discharging newborn babies into bed and breakfast or other unsuitable shared accommodation through the Child Poverty Strategy, which has now been published. We are working closely across the Government, including with the Home Office, to consider its implementation and any other associated impacts.

Asylum seeking families can access some of the support set out in the Child Poverty Strategy, including Best Start Family Hubs in England.

We are committed to reforming the dental contract, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly.

As a first step, from April 2026, we will be implementing reforms to the current National Health Service dental contract which are expected to improve access for patients with urgent and complex needs and to better reward dentists for treating these patients. From April, dental practices will be required to deliver a set proportion of their contract as urgent care, supported by increased payments for dentists. We are also introducing three new care pathways for patients with significant dental decay and gum disease, with payments to dentists ranging from £248 to £709 and patients paying one charge for the whole pathway.

By better incentivising urgent and complex care, we’re encouraging dentists to treat these patients, benefiting patients across the country.

We are committed to delivering further, fundamental reform of the dental contract before the end of this Parliament. This will include a full consultation on the future proposals and regular engagement with the sector, including the British Dental Association and other representatives.

We are committed to delivering fundamental reform of the dental contract before the end of this Parliament. As well as working towards a full consultation, we are continuing to engage with the sector regularly, including the British Dental Association and other representatives, to scope potential changes.

As a first step, from April 2026, we will be implementing reforms to the current National Health Service dental contract which are expected to improve access for patients with urgent and complex needs and to better reward dentists for treating these patients. From April, dental practices will be required to deliver a set proportion of their contract as urgent care, supported by increased payments for dentists. We are also introducing three new care pathways for patients with significant dental decay and gum disease, with payments to dentists ranging from £248 to £709 and patients paying one charge for the whole pathway.

By better incentivising urgent and complex care, we’re encouraging dentists to treat these patients, benefiting patients across the country.

All United Kingdom registered doctors are expected to meet the professional standards set out in the General Medical Council’s Good Medical Practice. The standards cover personal beliefs and medical practice, and set out that in assessing a patient’s conditions and taking a history, doctors should take account of spiritual, religious, social, and cultural factors, as well as their clinical history and symptoms.

The training curriculum for postgraduate trainee doctors is set by the Royal College of General Practitioners (RCGP) and has to meet the standards set by the General Medical Council. The RCGP curriculum includes content on ‘demonstrating the holistic mindset of a generalist medical practitioner’, which covers spirituality and cultural factors.

We know people are waiting too long for community services and that is why we have set a clear target for systems to work to reduce long waits in NHS England’s Medium Term Planning Framework. By 2028/29 at least 80% of community health service activity should take place within 18 weeks. In addition, in 2025 we published Standardising Community Health Services which provides an overview of the core community health services, with further detail published in February 2026.

As of January 2026, there were 1.4 million people on waiting lists for community health services, with 59,245 people who had been on waiting lists for 52 to 104 weeks, and 30,946 people who had been on waiting lists for over 104 weeks.

We know people are waiting too long for community services and that is why we have set a clear target for systems to work to reduce long waits in NHS England’s Medium Term Planning Framework. By 2028/29 at least 80% of community health service activity should take place within 18 weeks. In addition, in 2025 we published Standardising Community Health Services which provides an overview of the core community health services, with further detail published in February 2026.

As of January 2026, there were 1.4 million people on waiting lists for community health services, with 59,245 people who had been on waiting lists for 52 to 104 weeks, and 30,946 people who had been on waiting lists for over 104 weeks.

Patients in England are not registered with a National Health Service dental practice, although many NHS dental practices do tend to see patients regularly. There is no geographical restriction on which practice a patient may attend and there are no centrally held national waiting lists for NHS primary dental care. Some dental practices may operate local waiting list arrangements.

NHS dentists are required to keep their the NHS.UK website profiles up to date so that patients can find a dentist more easily. This includes information on whether they are accepting new patients. In circumstances where patients are unable to access an urgent dental appointment directly through an NHS dental practice, they should contact NHS 111.

The Government is committed to ensuring people can access urgent dental care when they need it. Over the past year, integrated care boards have been commissioning additional urgent dental appointments and there is now an urgent care safety net available in all areas of the country. 1.8 million additional courses of NHS dental treatment have been delivered in the seven months between April 2024 to October 2025 compared to the corresponding months prior to the general election.

We are committed to delivering fundamental reform of the dental contract before the end of this Parliament. As a first step, on 16 December we published the Government’s response to the public consultation on quality and payment reforms to the NHS dental contract. The changes will be introduced from April 2026. These reforms will put patients with greatest need first, incentivising treatment for those with urgent or more complex care needs. Further information is available at the following link:

https://www.gov.uk/government/consultations/nhs-dentistry-contract-quality-and-payment-reforms/outcome/government-response-to-consultation-on-nhs-dentistry-contract-quality-and-payment-reforms

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 require local authorities that provide adult social care services to have complaints procedures that follow a certain process. They should work with the person raising the complaint to try and resolve it.

If someone is not satisfied with the outcome of their complaint to the local authority, then the Local Government and Social Care Ombudsman (LGSCO) can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care. Details of how to complain to the LGSCO can be found at the following link:

https://www.lgo.org.uk/make-a-complaint

There is also a help and advice line available via telephone on 0300 061 0614, or one can write to The Local Government Ombudsman, PO Box 4771, Coventry, CV4 0EH.

Data is not published at a constituency level. In the Norfolk and Waveney Integrated Care Board (ICB), which includes the North West Norfolk constituency, 45,763 more National Health Service dental treatments were delivered in April to October 2025 compared to the same period before the election. Nationally, 1.8 million more NHS dental treatments were delivered across the same time period.

Data is also published annually at ICB level, which includes information on dental treatments delivered, as well as the proportion of adults and children seen by an NHS dentist. Data for 2024/25 can be found at the following link:

https://www.nhsbsa.nhs.uk/statistical-collections/dental-england/dental-statistics-england-202425

Information on the years prior to 2023/24 can be found at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics

Integrated care boards are continuing to recruit dentists through the Golden Hello scheme. The scheme offers a £20,000 recruitment incentive payment to dentists to work in those areas that need them most for three years. The recruitment of dentists in underserved areas remains a priority.

Golden Hello data will be published this year and will consist of data showing the regional distribution of the original allocation of posts and the number of posts recruited to at both a national and regional level.

Anyone who is concerned that an adult with care and support needs is at risk of, or experiencing abuse or neglect, can contact the safeguarding adults team at the relevant local authority to raise a safeguarding enquiry.

Where a local authority has reasonable cause to suspect that an adult in the local authority’s area has needs for care and support, whether or not the authority is meeting any of those needs, and appears to be at risk of, or experiencing abuse or neglect, and is unable to protect themselves as a result of those needs, the local authority must carry out a safeguarding enquiry.

Under section 68 of the Care Act 2014, local authorities must provide an independent advocate for adults involved in safeguarding enquiries when they would otherwise struggle to understand, retain, use, or weigh information, or to communicate their views.

Anyone who is concerned that an adult with care and support needs is at risk of, or experiencing abuse or neglect, can contact the safeguarding adults team at the relevant local authority to raise a safeguarding enquiry.

Where a local authority has reasonable cause to suspect that an adult in the local authority’s area has needs for care and support, whether or not the authority is meeting any of those needs, and appears to be at risk of, or experiencing abuse or neglect, and is unable to protect themselves as a result of those needs, the local authority must carry out a safeguarding enquiry.

Under section 68 of the Care Act 2014, local authorities must provide an independent advocate for adults involved in safeguarding enquiries when they would otherwise struggle to understand, retain, use, or weigh information, or to communicate their views.

When a local authority has reasonable cause to suspect an adult in the local authority’s area has care and support needs, is at risk of, or experiencing abuse or neglect, and cannot protect themselves because of those needs, it must carry out a safeguarding enquiry.

Local authorities must work with their partners under section 6(7) of the Care Act 2014, and those partners must also work with the authority to carry out their care, support, and adult protection duties.

Our 10-Year Health Plan sets out to tackle health inequalities and offer people with disabilities more holistic, on-going support in the community.

Action is underway to improve access and support for people with a learning disability through mandatory training for health and care staff, continued uptake of annual health checks and health action plans, and the Mental Health Act reforms.

When a local authority has reasonable cause to suspect an adult in the local authority’s area has care and support needs, is at risk of, or experiencing abuse or neglect, and cannot protect themselves because of those needs, it must carry out a safeguarding enquiry.

Local authorities must work with their partners under section 6(7) of the Care Act 2014, and those partners must also work with the authority to carry out their care, support, and adult protection duties.

Our 10-Year Health Plan sets out to tackle health inequalities and offer people with disabilities more holistic, on-going support in the community.

Action is underway to improve access and support for people with a learning disability through mandatory training for health and care staff, continued uptake of annual health checks and health action plans, and the Mental Health Act reforms.

Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

Decisions about care placements are made locally, based on individual assessments of need and personal circumstances. Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets and commission services to meet the diverse needs of all local people. This includes commissioning a variety of different providers and specialist services that provide genuine choice to meet the needs of local people, and that offer quality and value for money.

There is no single national assessment of the impact of out‑of‑area placements on disabled adults and their families. However, local authorities should engage with people who draw on care and support, and their families and carers, to inform commissioning decisions and to consider the outcomes which matter to them. This is reflected in the Care and Support Statutory Guidance, which supports local authorities to fulfil their Care Act duties, including expectations around involvement and co‑production with people who draw on care and support and their families.

The Department does not hold data on either the number of people waiting for a glaucoma follow-up appointment or the length of waiting time for any such glaucoma follow-up appointment. Therefore, no current estimate has been made.

Data is published on ophthalmology waiting times from referral to treatment, but this is not broken down by condition and does not cover follow up appointments that occur after a patient’s first definitive treatment.

As of January 2026, the waiting list for ophthalmology stands at 602,163, with 69.8% of those having waited less than 18 weeks from referral to treatment.

In 2025/26, the Quality and Outcomes Framework incentive payment for maintaining a palliative care register was retired, meaning general practices (GPs) no longer receive a payment for this activity. However, the use of palliative care registers did not cease, with GPs still able to actively maintain and use their register as part of good clinical practice, including proactive identification, personalised care, and support planning and ongoing reviews.

Early identification of someone who has palliative and end-of-life care needs is vital. There are tools to aid clinicians in identifying those approaching the end of life, for example the Supportive and Palliative Care Indicators Tool and the EARLY toolkit, which are available, respectively, at the following two links:

https://www.spict.org.uk/the-spict/

https://www.england.nhs.uk/north-west/north-west-coast-strategic-clinical-networks/our-networks/palliative-and-end-of-life-care/for-professionals/early-toolkit-for-primary-care/

The number of people identified as having palliative care and end-of-life care needs has risen, from 290,433 in 2022/23 to 356,543 in 2024/25.

Timely and equitable identification of palliative care and end-of-life care needs will be a key element of our Palliative Care and End-of-Life Care Modern Service Framework (MSF). NHS England and the Department are working closely with a wide range of stakeholders on the development of the MSF, looking at how we can enable more proactive assessment of palliative care need and subsequent access to services and personalised care and support, including advance care planning.

In 2025/26, the Quality and Outcomes Framework incentive payment for maintaining a palliative care register was retired, meaning general practices (GPs) no longer receive a payment for this activity. However, the use of palliative care registers did not cease, with GPs still able to actively maintain and use their register as part of good clinical practice, including proactive identification, personalised care, and support planning and ongoing reviews.

Early identification of someone who has palliative and end-of-life care needs is vital. There are tools to aid clinicians in identifying those approaching the end of life, for example the Supportive and Palliative Care Indicators Tool and the EARLY toolkit, which are available, respectively, at the following two links:

https://www.spict.org.uk/the-spict/

https://www.england.nhs.uk/north-west/north-west-coast-strategic-clinical-networks/our-networks/palliative-and-end-of-life-care/for-professionals/early-toolkit-for-primary-care/

The number of people identified as having palliative care and end-of-life care needs has risen, from 290,433 in 2022/23 to 356,543 in 2024/25.

Timely and equitable identification of palliative care and end-of-life care needs will be a key element of our Palliative Care and End-of-Life Care Modern Service Framework (MSF). NHS England and the Department are working closely with a wide range of stakeholders on the development of the MSF, looking at how we can enable more proactive assessment of palliative care need and subsequent access to services and personalised care and support, including advance care planning.

The first phase of the Carr-Hill review is expected to conclude in March 2026. Subject to ministerial decision, further work would be undertaken to technically develop and model any proposed changes to the formula. Findings from the review will be published in due course by the National Institute for Health and Care Research. Members of Parliament will be updated once the review findings are available.

Implementation of any new funding approach would be subject to ministerial decision and consultation with the General Practice Committee for England of the British Medical Association, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

NHS England has advised that, within the Nottingham and Nottinghamshire, and Lincolnshire clustered Integrated Care Board (ICB) boundary, 65 out of 81 practices, or 81%, in Lincoln are general practice (GP) partnership model practices. 115 out of 126 of practices, or 91%, in Nottingham and Nottinghamshire are GP partnership model practices.

Within the NHS Leicester, Leicestershire and Rutland ICB boundary, 115 out of 126 practices, or 90%, are GP partnership model practices. Within the Northamptonshire ICB boundary, 64 out of 65 practices, or 98%, are GP partnership model practices.

Within the NHS Derby and Derbyshire ICB boundary, 99 out of 109 practices, or 89%, are traditional GP partnerships. The other 10, or 11%, are partner-run, but not in the traditional way. Of these:

- four are managed by Royal Primary Care, Chesterfield;

- four are managed by Derbyshire Community Health Services; and

- two are managed by Derbyshire Healthcare United.

In the Broxtowe constituency, 11 out of 11 practices are GP partnership model practices. The Department does not hold national-level data, however, we expect that a large majority of practices in England operate as traditional GP partnerships.

The first phase of the Carr-Hill review is expected to conclude in March 2026. Subject to ministerial decision, further work would be undertaken to technically develop and model any proposed changes to the formula.   Findings from the review will be published in due course by the National Institute for Health and Care Research. Members of Parliament will be updated once the review findings are available.

Implementation of any new funding approach would be subject to ministerial decision and consultation with the General Practice Committee for England of the British Medical Association, in the context of the available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

The data requested is not held centrally. Thanks to actions taken by the Government, we have the highest number of fully qualified general practitioners (GPs) since 2015, and steps are being taken to grow the GP workforce further.

We are investing £485 million in GPs in 2026/27, bringing the total spend on the GP Contract to over £13.8 billion. This builds on the £1.1 billion boost in investment in 2025/26. As part of the 2026/27 GP Contract, we are increasing flexibility of the Additional Roles Reimbursement Scheme (ARRS) by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling primary care networks to recruit a broader range of ARRS roles, where agreed with the commissioner.

Patient satisfaction is already rising after a decade of decline; in July 2024, only 61% of patients found it easy to access their GP. Currently, it is almost 77%.

Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level GP reimbursement scheme which ring-fences and repurposes £292 million of funding from the current Capacity and Access Payment. This funding will be available to practices to hire additional GPs or fund additional sessions with existing GPs to improve access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment.

The Early Access to Medicines Scheme (EAMS), is an existing pathway across the regulatory and access system designed to support innovative treatments being available to patients who need them earlier in the development cycle, outside of a clinical trial. The Government is collaborating across the regulatory system to continuously review the effectiveness of these pathways.

Pharmaceutical companies may also put in place arrangements to provide early access to medicines outside EAMS. Working with colleagues at NHS England, the Department is continuing to engage with companies and patient groups regarding early access schemes that are enabled by manufacturers providing free of charge medicines, in advance of any recommendation from the National Institute for Health and Care Excellence. We are presently working to get a fuller picture of the costs of, and barriers to, and opportunities for early access schemes being offered by National Health Service trusts.

People with spinal cord injuries in North Shropshire receive specialist care through the Midland Centre for Spinal Injuries (MCSI) at the Robert Jones and Agnes Hunt Orthopaedic Hospital, one of 11 nationally designated spinal injury centres providing lifelong multidisciplinary support in the United Kingdom. MCSI provides multidisciplinary rehabilitation and lifelong follow up care for spinal cord injury patients.

Nationally, spinal cord injury services form part of prescribed specialised services, with NHS England maintaining national service standards, specifications, and clinical policies. From 2025, elements of specialised commissioning were delegated to integrated care boards to support more integrated pathways, while overall accountability remains with NHS England.

In March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

The Getting It Right First Time (GIRFT) Programme for spinal services is also driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from, thereby aiming to reduce regional variation in the quality of care patients with spinal cord injuries receive.

People with spinal cord injuries in North Shropshire receive specialist care through the Midland Centre for Spinal Injuries (MCSI) at the Robert Jones and Agnes Hunt Orthopaedic Hospital, one of 11 nationally designated spinal injury centres providing lifelong multidisciplinary support in the United Kingdom. MCSI provides multidisciplinary rehabilitation and lifelong follow up care for spinal cord injury patients.

Nationally, spinal cord injury services form part of prescribed specialised services, with NHS England maintaining national service standards, specifications, and clinical policies. From 2025, elements of specialised commissioning were delegated to integrated care boards to support more integrated pathways, while overall accountability remains with NHS England.

In March 2025, NHS England published the Spinal Services Clinical Network Specification, which establishes expectations for spinal clinical networks to standardise pathways and reduce variation, with the aim of improving access to care for patients.

The Getting It Right First Time (GIRFT) Programme for spinal services is also driving service improvements and better care for patients with spinal cord injuries. GIRFT has worked with National Health Service trusts to showcase examples of best practice which other services can then learn from, thereby aiming to reduce regional variation in the quality of care patients with spinal cord injuries receive.