Department of Health and Social Care

In January 2025, following public consultation, NHS England published an updated NHS Commercial Framework for New Medicines. This framework includes the approach for assessing the eligibility for medicines that may treat multiple indications to qualify for indication-specific pricing, and the terms for doing so. Following consultation, NHS England adopted the following criteria for the use of indication-specific pricing:

- the medicine for the indication under consideration meets an unmet clinical need;

- the company can demonstrate with a high degree of confidence that uniform pricing would reduce the total revenue for a medicine across all indications;

- sufficient data is available within existing National Health Service systems to make such arrangements operationally feasible; and

- the cost-effective price is highly differentiated for all indications under consideration.

NHS England’s approach to indication-specific pricing has supported patient access to medicines for many new indications which would otherwise have been unavailable if the only alternative was a uniform price for all indications. The National Institute for Health and Care Excellence is able to recommend the vast majority of medicines for use in the NHS, including medicines licensed for multiple indications. The latest European Federation of Pharmaceutical Industries and Association’s Patients Waiting to Access Innovative Therapies Indicator report 2024, published in May 2025, reports that the 37% of medicines licensed between 2020 and 2023 were fully available to NHS patients in England, compared with an European Union average of 29%.

As agreed under the terms of the Voluntary Scheme for Branded Medicines Pricing, Access and Growth, and subsequently set out in the NHS England consultation response, indication-specific pricing agreements will continue to be reserved for medicines that are normally expected to have value propositions at or below the lower end of the National Institute for Health and Care Excellence’s cost-effectiveness range.

The Life Sciences Sector Plan committed to faster patient access to medicines and reduced industry costs, while ensuring good value for the NHS. A new, proportionate approach to National Institute for Health and Care Excellence appraisals and indication-specific pricing will streamline access for multi-indication medicines with strong outcomes and low affordability risk. This will create a more agile, predictable commercial environment that supports investment into the United Kingdom.

The criteria will be developed alongside the new proportionate approach to indication-specific pricing arrangements.

The criteria will be developed alongside the new proportionate approach to indication-specific pricing arrangements.

Fracture Liaison Services are commissioned by integrated care boards, which are well-placed to make decisions according to local need.

Our 10-Year Health Plan committed to rolling out Fracture Liaison Services across every part of the country by 2030.

The Department is working closely with NHS England to consider a range of options to ensure better quality and access to these important preventative services.

All providers in Devon are asked to follow the formulary within the services they provide. The formulary provides information on continence care, with further information available at the following two links:

https://southwest.devonformularyguidance.nhs.uk/formulary/chapters/18-continence

https://northeast.devonformularyguidance.nhs.uk/formulary/chapters/18-continence

As part of focused work in gynaecology, NHS Devon is in a project development phase to design and implement improved pathways for women with stress urinary incontinence and overactive bladder conditions.

Livewell Southwest provides a continence service, offering assessments to adults, those aged 17.5 years old and above, living in Plymouth, West Devon, and South Hams. Livewell provides a holistic continence assessment, including routine observations, bladder scans, and skin integrity checks, as well as reviewing past medical history, medication, mobility, carer support, and diet and fluid. They offer ongoing support and products for any bowel and/or bladder issues that are identified and may refer patients to specialist nurses for further support or district nurses for ongoing care.

Conservative advice is always given as first line management options during assessments, such as pelvic floor exercises for stress urinary incontinence, or bladder training and fluid intake advice for an overactive bladder. Livewell also liaises with general practices to request medication and to request ongoing referrals to secondary care specialists if needed. Livewell works closely with the other community teams. All patients are offered an annual reassessment.

For children and young people, there is a team of specialist children’s nurses and specialist nursery nurses who provide assessment, treatment, support, and advice for children and young people with bladder and/or bowel difficulties. They provide continence promotion, and healthy bladder and bowel advice for children with additional needs. They see and assess children who are eligible for continence products because of a learning or physical disability.

Devon has commissioned a paediatric integrated community nurse led bladder and bowel service for children and young people up to the age of 19 years old, to improve quality of life, to support effective self-management where appropriate, and to prevent chronic conditions developing and needing treatment or surgery in secondary care where possible.

The 10-Year Health Plan is not based on a specific percentage growth rate in demand for health care. Instead, backed by an additional £29 billion, the plan sets out how the health system will seize the opportunities provided by new technology, medicines, and innovation to deliver better care for all patients, no matter where they live or how much they earn, as well as better value for taxpayers.

Experiencing pregnancy or baby loss can be extremely difficult and traumatic. We are determined to make sure that all bereaved parents, regardless of where they live, have access to specialist psychological support.

As of June 2025, Maternal Mental Health Services are now available in all areas of England. These services provide specialist psychological support for women with moderate/severe or complex mental health difficulties arising from birth trauma or baby loss.

All trusts in England are also signed up to the National Bereavement Care Pathway. This pathway is designed to improve the quality and consistency of bereavement care for parents and families experiencing pregnancy or baby loss.

We also recognise the importance of maternity bereavement services being available at all times. Seven day a week bereavement services are in the process of being set up in every area in England to support women and families who experience pregnancy loss or neonatal death.

The product information for each medicine possibly associated with teratogenic effects includes details about the nature and severity of the risk. The product information is intended to support and not replace the discussion between a healthcare professional and their patient regarding their treatment options.

The Medicines and Healthcare products Regulatory Agency continuously monitors the safety of medicines, including their use during pregnancy, ensuring the product information reflects what is known about each medicine.

The suppliers used for Black History Month were Eurest Services, for catering services that cost £69.

The Medicines and Healthcare products Regulatory Agency (MHRA) issued a field safety notice (FSN) in December 2022 about some devices in the NexGen family of knee implants. The FSN was issued following notification by the National Joint Registry (NJR) Implant Scrutiny Committee in 2021.

The NexGen Stemmed Option Tibial Component was removed from the market because of that notice, although only use in combination with LPS Flex or LPS Flex GSF femoral components demonstrated higher revision rates, and only patients receiving the combination of devices were recommended to be reviewed.

As is standard with joint replacement FSNs, the NJR supplied hospitals with a list of all the patients who had this combination implant and were still alive and had not already had a revision procedure. This represented 9,125 cases from 102 hospitals. This all happened within 48 hours of the FSN being issued. For context, 11,965 of these were implanted if patients who had died or been revised were included.

In terms of the clinical impact, the NJR had first been asked to investigate use of high flex NexGen knees by a surgeon in 2014. Although the data did not meet the outlier threshold at that time, NJR did inform the MHRA because there appeared to be a particular mechanism of failure with these devices, namely tibial loosening. The MHRA followed its standard process of discussing the concerns with the manufacturer and the matter was closed since the data did not demonstrate a case to answer. NJR reported this again in 2021, by which time the data was more robust and the signal was stronger.

At the time for an implant to be rated 10A, which is a measure of implant success, according to the National Institute for Health and Care Excellence (NICE), a failure rate of 10% at 10 years was used. This has recently been changed to a failure rate of 5% at 10 years.

The failure rate of this implant combination at 10 years is 7%, which is still under the 10% threshold advocated by NICE. It is important that these patients remain under clinical and radiological review.

NJR has made no assessment of the financial impact of the NexGen family of knee implants.

The House of Commons has voted to add a clause to the Crime and Policing Bill which disapplies the criminal offences related to abortion for a woman acting in relation to her own pregnancy. These offences would still apply to medical professionals and third parties who do not abide by the rules set out in the Abortion Act 1967. The bill will now continue its progress through Parliament.

Informed consent is separate from the requirements set by the Abortion Act for two doctors to certify that a woman meets the grounds for abortion. Consent to treatment means a person must give permission before they receive any type of medical treatment, test, or examination. For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These principles will continue to apply irrespective of whether abortion is decriminalised.

As part of standards set by the Care Quality Commission, abortion services must be able to prove that they have processes in place to ensure that all women and girls are seeking services voluntarily. It will also remain a requirement for an abortion service, as laid out in the Department’s Required Standard Operating Procedures, that staff should be able to identify those who require more support than can be provided in the routine abortion service setting, for example young women, those with a pre-existing mental health condition, those who are subject to sexual violence or poor social support, or where there is evidence of coercion.

Safeguarding is an essential aspect of abortion care, and abortion providers are required to have effective arrangements in place to safeguard children and vulnerable adults accessing their services. Providers must ensure that all staff are trained to recognise the signs of potential abuse and coercion and know how to respond. In addition, the Royal College of Paediatrics and Child Health has published national safeguarding guidance for under-18 year olds accessing early medical abortion services, which aims to ensure that robust safeguarding processes are embedded in all services. We expect all providers to have due regard to this guidance.

The Department is continuing to monitor abortion related amendments to the Crime and Policing Bill and will consider whether current arrangements are sufficient or if additional guidance is needed.

Women seeking abortion services must be given impartial, accurate, and evidence-based information so that they are able to make an informed choice about their preferred course of action.

The National Health Service website provides factual information on abortion, including directing people seeking impartial information and support to their general practice or to regulated organisations such as Brook, for under 25 year olds, the British Pregnancy Advisory Service, MSI Reproductive Health Choices UK, and National Unplanned Pregnancy Advisory Service. All the main abortion providers offer pregnancy counselling, which includes advice on options such as parenting and adoption.

Following a diagnosis of fetal anomaly, women and their partners must receive appropriate counselling and support. At no stage should there be a bias towards abortion. All staff involved in the care of a woman or couple facing a possible termination of pregnancy must adopt a nondirective, non-judgemental, and supportive approach. It should not be assumed that a woman will choose to have a termination, and a decision to continue with the pregnancy must be fully supported. In addition, the charity Antenatal Results and Choices offers information and support for people who have received a diagnosis after antenatal screening.

NHS England is due to review the Foundation Programme allocation process. The review is aiming to commence in 2026. NHS England will advise stakeholders, including the British Medical Association, on how they can input in due course.

As set out in our 10-Year Health Plan, published on 3 July, we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period, for specialty training.

NHS England is due to review the Foundation Programme allocation process. The review is aiming to commence in 2026. NHS England will advise stakeholders, including the British Medical Association, on how they can input in due course.

As set out in our 10-Year Health Plan, published on 3 July, we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period, for specialty training.

NHS England is due to review the Foundation Programme allocation process. The review is aiming to commence in 2026. NHS England will advise stakeholders, including the British Medical Association, on how they can input in due course.

As set out in our 10-Year Health Plan, published on 3 July, we will work across Government to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period, for specialty training.

We have recently announced the Spending Review settlement, which provides an additional £29 billion of annual day-to-day spending in real terms by 2028/2029 compared to 2023/2024. Ahead of asking the National Health Service to commence a multi-year planning round, we are now carefully reviewing how the settlement is prioritised, including making provision for redundancy costs. At this stage, it is too early to say what the upfront costs of integration are, including any redundancy, while transition planning is ongoing.

While there will be some upfront costs, we expect the reform to eliminate duplication and drive a smaller centre, based in a single organisation, that will generate significant savings in the long run, which can be diverted to the front line.

In the last financial year, 2024/25, 95.7% of procurement contracts were awarded to suppliers which reported to the Department that their legal entity is registered in the United Kingdom, in the UK Companies House Register.

Contract award decisions in the National Health Service which may involve the transfer of staff delivering “soft” facilities management services to other suppliers fall directly to individual NHS bodies, who are responsible for running their own procurement exercises. Ministers at the Department do not have general powers in legislation to direct trusts in relation to the exercise of any of their functions, including in relation to specific contractual decisions.

The Transfer of Undertakings (Protection of Employment) Regulations (TUPE) allow for terms and conditions of service to be protected or frozen as they stand on the date of transfer to a new employer. This includes annual leave entitlement and sick pay. Under the Fair Deal for Staff Pensions policy, employees who are members of the NHS Pension Scheme can retain access to their existing pension arrangements, or be offered a comparable scheme by the new employer. The Government expects that any outsourced services are delivered by trusts in a way that improves quality, ensures greater stability and longer-term investment in the workforce, and delivers better value for money, as part of the broader commitments on procurement, as set out in the Make Work Pay programme, with further information available at the following link:

https://www.gov.uk/government/collections/make-work-pay

NHS staff continue to work incredibly hard on delivering the best possible care for patients, and wherever they work across the health service, we expect the highest standards and good terms and conditions.

The Department and NHS England have had no communications with the Professional Records Standards Body about the definition of gender identity and gender.

The Department is supportive of the work of volunteer initiatives, such as SOS buses. Voluntary, community, and social enterprise organisations (VCSEs) play a vital role in supporting communities up and down the country with a huge variety of issues. However, I recognise that the last few years have created a difficult environment for VCSEs, due to a number of challenges including those related to the COVID-19 pandemic and cost of living, and many are seeing increased financial pressures.

The Department for Digital, Culture, Media and Sport is supporting VCSEs with their financial sustainability, including through the delivery of a number of grant programmes, growing other sources of funding such as the social investment market, and supporting the viability of local government contracts. There are a number of ways in which organisations can find available funding opportunities, including:

• the Find a Grant service, which allows you to search for Government grants. The filtering system allows you to select grants which are open to applications from non-profits, with further information available at the following link: https://www.gov.uk/guidance/find-government-grants;
• funding opportunities hosted by The National Lottery Community Fund, with further information available at the following link: https://www.tnlcommunityfund.org.uk/funding;
• funding and income guidance from the National Council for Voluntary Organisations, which includes a section on where to find grants available to charities, with further information available at the following link: https://www.ncvo.org.uk/help-and-guidance/funding-income/#/;
• most areas of the country have Community Foundations that manage at least one local grant fund, or can offer guidance, with further information available at the following link: https://www.ukcommunityfoundations.org/; and
• local civil society infrastructure organisations may be able to signpost people to local grants and funding. The National Association for Voluntary and Community Action members often provide this type of support, with further information available at the following link: https://www.navca.org.uk/find-a-navca-member.

The Government has made it a priority to reset the relationship with civil society and build a new partnership to harness its full potential by developing a Civil Society Covenant.

Further, if local healthcare commissioners judge that SOS buses would help meet the healthcare needs of their respective populations, they can choose to commission those services.

Such a decision would be taken at the local level as integrated care boards across England are responsible for managing the National Health Service budget and arranging NHS healthcare services which meet the needs of their respective populations.

There is no formal policy supporting minimum waits in the National Health Service. However, the NHS Standard Contract technical guidance for 2025/26 states that commissioners may choose to include minimum waiting times in Activity Planning Assumptions to ensure the delivery of targets within agreed financial allocations. The full guidance is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2025/04/08a-nhssc-2526-contract-technical-guidance-final.pdf

Patients continue to have a legal right to choose where they go for their first appointment when referred to consultant-led care as an outpatient.

We will work closely with all systems to ensure they deliver the expected level of improvement in waiting times set out in 2025/26 Planning Guidance, which is the first step in delivering on our commitment that by March 2029, 92% of patients wait no longer than the constitutional standard of 18 weeks from referral to consultant-led treatment.

No specific estimate has been made. The Fit for the Future: 10-Year Health Plan for England commits to giving people more choice and control over their care. We have committed to at least doubling the number of people offered a personal health budget by the 2028/29 financial year, and we will make personal health budgets a universal offer for all who would benefit from them by 2035.

The Department does not currently hold data on the overall cost to the National Health Service of treating complications arising from procedures carried out overseas. However, we are actively exploring ways to better understand the scale and impact of these costs on NHS services.

We will publish our 10 Year Workforce Plan by the end of this year. The plan will set out the workforce needed to deliver the transformed service, and the key assumptions used in determining that workforce. That plan will set out assumptions about productivity used in determining projected staff numbers.

The approach set out in our 10-Year Health plan means that we will need a very different kind of workforce strategy. Instead of asking ‘how many staff do we need to maintain our current care model over the next 10 years?’, our new 10 Year Workforce Plan will ask ‘given our reform plan, what workforce do we need, what should they do, where should they be deployed, and what skills should they have?’

Existing criminal offences relating to fetuses are contained in the Offences Against the Person Act 1861 and the Infant Life Preservation Act 1929.

The House of Commons has voted to add a clause to the Crime and Policing Bill which disapplies the criminal offences related to abortion for a woman acting in relation to her own pregnancy. These offences would still apply to medical professionals and third parties who do not abide by the rules set out in the Abortion Act 1967. The Government has no plans to change these.

The information is not available in the format requested, as national personal health budget data prior to 2019 is not held. The following table shows the uptake of personal health budgets in England by the end of Quarter 4 in each financial year from 2019/20 to 2024/25:

Source: NHS England Digital, available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/personal-health-budgets

The data under each financial year is cumulative in-year data, and for each financial year the figure shown is the number of people who had received a personal health budget in England by the end of Quarter 4.

2019/20 only includes cumulative data up to Quarter 3 due to COVID-19. No cumulative data was published up to Quarter 4 2020/21 due to COVID-19.

NHS England has written to National Health Service trusts, integrated care boards, and primary care networks to reiterate their responsibilities to their staff as employers, including providing pastoral support where required. Importantly, NHS England has also written directly to staff most affected by the recommendations, in the Response to Recommendations from the Independent Review of Physician Associates and Anaesthesia Associates (the Leng Review), available on the NHS.UK website, setting out where they can find support if required.

Implementing the recommendations will require organisations to work together and take action. Some actions will be implemented immediately, whilst others will require wider input, with benefits being fully realised over time. The Department and NHS England will work to ensure that both patient and staff needs are met throughout this process. We will also work collaboratively with other key partners to set out a clear implementation plan for making the required changes, in advance of publishing a fuller response.

On 7 April 2025 the Prime Minister announced that the Government and the Wellcome Trust will invest up to £600 million to create a new Health Data Research Service, co-designed through engagement with the public and patients, data users, and stakeholder organisations.

Providing access to data for direct care purposes is not one of the Health Data Research Service’s planned capabilities. The Health Data Research Service will deliver a single point of access to health data for research from multiple sources, National Health Service and non-NHS. This service will bring new treatments and cures to patients by safely enabling the use of patient data to super-charge research, attracting investment and making the United Kingdom one of the best places in the world to conduct ground-breaking medical research.

The Health Data Research Service will be delivered across the UK to provide a single, integrated system for approved researchers across all sectors to access health, social care, and public health data safely. The service will streamline and simplify current processes, ensuring the safety and security of the data, allowing researchers to spend less time talking to different NHS bodies around the country and more time unlocking new insights that will transform our understanding of health.

On 3 July 2025, the Government announced the 10-Year Health Plan and set out its vision for a Neighbourhood Health Service to bring care into local communities, transform access to health services, and prevent unnecessary hospital admissions.

Neighbourhood Health Centres will play a key role in realising this vision and transforming healthcare access by bringing historically hospital-based services into communities and addressing wider determinants of health in communities across the country, including in places like Yeovil.

On 21 July 2025, I wrote to Members of Parliament highlighting that the Department and NHS England have written to integrated care boards (ICBs) and local authorities to invite applications from local places to participate in the National Neighbourhood Health Implementation Programme.

We are determined to rebuild National Health Service dentistry and deliver a dentistry service fit for the future.

No recent assessment has been made. The 10-Year Health Plan has set out a new service model for the NHS. The 10 Year Workforce Plan will assess what this means for the workforce, and will ensure we have the right people, in the right places, with the right skills to care for patients when they need it.

We are regularly engaging with the sector on a range of issues, including workforce recruitment and retention. For instance, the Department has held two roundtables in the last month with dentists, dental nurses, dental therapists and dental hygienists sharing their views on the changes we are making to NHS dentistry.

Through our 10-Year Health Plan, it will be easier and faster to see a general practitioner (GP). The 8:00am scramble will end, we will train more doctors, and we will guarantee digital consultations within 24 hours. We have delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of National Health Service resources

In October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of 1,900 individual GPs into primary care networks across England, which has expanded capacity, and will help to make same-day appointments more available to the patients that need them.

The new £102 million Primary Care Utilisation and Modernisation Fund will create additional clinical space within over 1,000 practices across England, enabling more appointments and supporting same-day access.

Data on Golden Hellos will be published by the end of August 2025. Once a publication date has been confirmed, this will be announced on the NHS England website.

As well as being able to access all national health services across the United Kingdom, NHS England has also introduced several bespoke services to improve healthcare support available to veterans. These are: Op RESTORE which supports veterans with service-related physical health problems; Op COURAGE which supports veterans with a mental health pathway; and Op NOVA which supports veterans in the justice system.

In addition, the veteran-aware trust and the veteran-friendly accreditation schemes raise awareness amongst healthcare professionals of the specific needs of veterans. These schemes provide support to ensure appropriate signposting and referrals to relevant veteran and wider services within the National Health Service.

In May 2025, a national training and education plan was announced to help veterans benefit from improved and targeted healthcare. NHS staff across England will receive dedicated training to help them identify and support patients with military backgrounds. This will be rolled out across the NHS from 1 October 2025.

The investigation will carry out rapid reviews of up to ten trusts with specific issues. The process of determining which trusts to review is ongoing, and once decided, they will be announced as soon as possible.

The information on payments received from National Health Service penalty charges for Prescription Exemption Checking Service (PECS) and Dental Exemption Checking Service from 2020 to 2024, broken down by age group is shown in the attached tables. This data is based on the date the payment was received rather than when the penalty charge was issued. Please note, ‘unknown’ dates of birth in the PECS data set are cases where a date of birth is present but cannot be accurately read.

At the end of June 2025, the Department had 90 full-time equivalent staff working in the Communications Directorate.

In NHS England, there are 328.8 full-time equivalent staff sitting under Communications in the Strategy Directorate. These individuals cover a wide range of communication roles and support functions, including business operations, system and stakeholder engagement, events and visit teams, and Parliamentary briefing and Freedom of Information management. There are a further six members of staff, who work in ‘Communications’ or ‘Comms’ teams in the wider business, which includes individuals working in Freedom of Information management and Parliamentary business.

Individual mental health trusts and local health systems are expected to effectively assess and manage their bed capacity. NHS England’s mental health, learning disability, and autism inpatient quality transformation programme is supporting cultural change and a new model of care across all National Health Service-funded mental health inpatient services, so that people can access timely, high-quality community support, closer to their families and loved ones. Local health systems have now published their three-year plans for localising and realigning inpatient care, in line with this vision.

As set out in our 10-Year Health Plan, we are focussing on treatment that is away from hospital and inpatient care and are making sure that more mental health crisis care is delivered in the community through new models of care and support, so that fewer people need to go into hospital.

NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.

NHS England and the British Association of Dermatologists have established a specialist dermatology clinical reference group. Its objectives are to: measure and improve quality; improve value and reduce unwarranted variation; improve equity of service; and transform and provide advice and support to integrated care boards as they take on responsibility for specialised service commissioning.

In addition, NHS England’s Getting It Right First Time (GIRFT) programme is working to improve capacity and waiting times through its established Further Faster programme. This programme brings together hospital trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways, reduce unnecessary follow-up outpatient appointments and improve access and waiting times for patients, including dermatology patients.

A Further Faster handbook for dermatology has been produced, to share best practice and support National Health Service dermatology teams to reduce the number of Did Not Attend appointments, reduce unnecessary follow ups and, where appropriate, reduce the number of outpatient appointments by booking patients straight to tests, helping to free up capacity for patients in need of specialist dermatology services.

The GIRFT team is carrying out regular visits to and meetings with challenged departments to support them in this work.

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

The following table shows the median average length of stay for adults and children who were discharged from mental health inpatient units in England between 1 March and 31 May 2025:

Source: Mental Health Services Dataset, NHS England.

No comparison can be made with the average length of stay for physical health inpatient admissions. NHS England has advised that data is not collected under the description of ‘physical health’ as the term is too broad.

As part of our mission to build a National Health Service that is fit for the future and is there when people need it, we are over halfway towards our target to recruit an extra 8,500 mental health staff. NHS England is also working to improve retention within the mental health workforce through clearer career progression pathways.

HM Treasury has provided funding to cover the additional cost of employer National Insurance contributions for public sector employers only. This is based on the Office for National Statistics definition of public sector organisations and does not include independent primary care contractors such as dentists.

We recognise this is disappointing, but we have had to take necessary decisions to fix the foundations in the public finances. The National Health Service in England invests approximately £4 billion on dentistry every year, of which £3 billion is spent on primary care dentistry. NHS planning guidance is now published and sets out funding available to integrated care boards for 2025/2026.