Olivia Blake

The Spending Review in June 2025 allocated £616 million for Active Travel England to support local authorities to build and maintain walking and cycling infrastructure from 2026/27 onwards, including dedicated cycling routes. This comes on top of £222.5 million announced in February 2025 for local authorities over 2024/25-25/26. Local authorities are responsible for deciding on how to invest the funding, in line with local priorities.

The Highway Code was updated in 2022 to include changes to improve safety for cyclists, pedestrians and horse riders, including guidance on safe passing distances and speeds and the introduction of a hierarchy of road users. The Department ran a THINK! campaign to raise awareness of the changes as they came into effect. This was followed by broader behaviour change campaigns in the summer of 2022 and 2023, to help embed the changes and encourage understanding and uptake of the guidance.

We also promote cycle safety advice for cyclists and motorists via THINK! social channels, education resources and run radio filler advertising encouraging motorists to maintain safe driving distances from cyclists and horse riders and to use the Dutch Reach when opening car doors to help keep cyclists safe.

The Department has not made any assessment of the potential impact of increasing the size of car bonnets on pedestrian or cyclist safety. All mass-produced cars are required to meet pedestrian protection requirements which are designed to protect pedestrians and cyclists in the event of a crash.

However, we are aware of the issue and intend to commission some work in this area to fully understand the impact of the trend in increased bonnet height.

The Highway Code was updated in 2022 to include changes to improve safety for cyclists, pedestrians and horse riders, including guidance on safe passing distances and speeds and the introduction of a hierarchy of road users. The Department ran a THINK! campaign to raise awareness of the changes as they came into effect. This was followed by broader behaviour change campaigns in the summer of 2022 and 2023, to help embed the changes and encourage understanding and uptake of the guidance.

We also promote cycle safety advice for cyclists and motorists via THINK! social channels, education resources and run radio filler advertising encouraging motorists to maintain safe driving distances from cyclists and horse riders and to use the Dutch Reach when opening car doors to help keep cyclists safe.

The Department has not made any assessment of the potential impact of increasing the size of car bonnets on pedestrian or cyclist safety. All mass-produced cars are required to meet pedestrian protection requirements which are designed to protect pedestrians and cyclists in the event of a crash.

However, we are aware of the issue and intend to commission some work in this area to fully understand the impact of the trend in increased bonnet height.

The Highway Code was updated in 2022 to include changes to improve safety for cyclists, pedestrians and horse riders, including guidance on safe passing distances and speeds and the introduction of a hierarchy of road users. The Department ran a THINK! campaign to raise awareness of the changes as they came into effect. This was followed by broader behaviour change campaigns in the summer of 2022 and 2023, to help embed the changes and encourage understanding and uptake of the guidance.

We also promote cycle safety advice for cyclists and motorists via THINK! social channels, education resources and run radio filler advertising encouraging motorists to maintain safe driving distances from cyclists and horse riders and to use the Dutch Reach when opening car doors to help keep cyclists safe.

The Department has not made any assessment of the potential impact of increasing the size of car bonnets on pedestrian or cyclist safety. All mass-produced cars are required to meet pedestrian protection requirements which are designed to protect pedestrians and cyclists in the event of a crash.

However, we are aware of the issue and intend to commission some work in this area to fully understand the impact of the trend in increased bonnet height.

The British Transport Police’s (BTP) budget is set currently set by the British Transport Police Authority (BTPA). It is the executive non-departmental public body that oversees the Force and is their employer. BTPA sets the BTP’s budget annually following proposals from the Force and views from industry.

We anticipate that the level of funding for the BTP during the transition to and commencement of Great British Railways will similarly balance the needs of the industry and the force against public sector affordability.

The British Transport Police’s (BTP) budget is set by the British Transport Police Authority (BTPA). It is the executive non-departmental public body that oversees the Force and is their employer. BTPA sets the BTP’s budget annually following proposals from the Force and views from industry. Set against a backdrop of wider public sector efficiencies and affordability by the rail industry it has agreed a budget increase for the financial year 2025/26 of 5.9%. BTP work closely with BTPA and industry operators to make final resourcing decisions with their agreed budget.

The cost of policing the rail network in Great Britain is primarily covered through the funding agreements that the British Transport Police Authority holds with Network Rail, the rail operators and Transport for London.

The Government is in the early stages of formulating a rolling stock strategy. The strategy will include considerations around the timelines for new build, refurbishments, and potential cascades which will provide more visibility to the rolling stock market.

The Medicines and Healthcare products Regulatory Agency (MHRA) is required to determine whether products are medicines on a case-by-case basis, taking into account the definition of a medicine in the Human Medicines Regulations 2012, relevant case law, and any other evidence.

There are many products which modify physiological function but which are not medicinal products, and case law has established that products that do so while having no beneficial effects on human health cannot be medicines.

Melanotan II injections and pens are considered medicinal products due to their similarity to an authorised medicinal product and potential application to other medical conditions.

However, tan-enhancing nasal products which are clearly marketed for self-tanning purposes and which do not have a medical purpose do not fall under medicines regulations and are not within the MHRA’s remit.

The Government is taking steps to prevent, diagnose, and treat cancers more quickly, including skin cancers. The forthcoming National Cancer Plan will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care. It will set out how we will improve outcomes for cancer patients, including by speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately driving up this country’s cancer survival rates. We will publish the National Cancer Plan in the new year to reduce the number of lives lost to cancer over the next 10 years.

We received over 11,000 responses to our call for evidence from individuals, professionals, and organisations, and we are reviewing the submissions from skin cancer partners. While no formal assessment has been made of the availability and levels of the use of tan-enhancing products containing Melanotan II, respondents shared concerns about tanning products and their potential links to cancer, particularly melanoma. Our expansive engagement will allow the National Cancer Plan to have patients at its heart.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for the regulation of medicinal products and medical devices in the United Kingdom.

Although tanning is not considered to be a medical purpose, injectable products containing Melanotan I or Melanotan II have been determined as medicinal products due to their similarity to the authorised medicine Scenesse.

In relation to nasal sprays containing Melanotan I or Melanotan II, there are no equivalent authorised medicines, and in the absence of medicinal claims, they are not regarded as medicinal products.

Medicinal products must hold a relevant Marketing Authorisation to be legally sold and supplied in the United Kingdom. This also guarantees that the medicines have been tested for conformity with strict standards of quality, safety, and efficacy. The MHRA takes action when a medicinal product without appropriate authorisations is identified.

A Freedom of Information (FOI) request is a request for recorded information held by that public authority. The Department is only able to respond to requests for information that it holds at the time of the request, and interaction with other public authorities on FOIs is therefore limited. All requests must be handled in line with the principles of the FOI Act and the guidance issued by the Information Commissioner's Office, as the FOI regulator. There is therefore no ability at present for the Department to operate a separate process for any specific topics or areas of interest.

The principal question of the Leng Review was to assess whether the roles of physician assistants (PAs) and physician assistants in anaesthesia, still legally known as physician associates and anaesthesia associates, are safe and effective. The review’s findings were clear that, with changes in line with its recommendations, there remains a place for these roles to continue as supportive, complementary members of medical teams.

The review recommendations include ensuring that PAs have the opportunity for ongoing training and development in the context of a formal certification and credentialling programme.

Professor Leng will be undertaking a temporary and continuing role to support the implementation of the recommendations, which will include driving wider discussions with a range of system partners including NHS England, the General Medical Council, royal colleges, professional bodies, and higher education institutions to consider further the changes needed to implement the recommendations.

We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. Our forthcoming 10 Year Workforce Plan will look at how to get the right people, in the right places, with the right skills to deliver the best care, and we will consider the findings of the Leng Review when developing the plan.

The Government is committed to protecting those most vulnerable to COVID-19 through vaccination, as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI).

In its advice for autumn 2024, the JCVI advised that in the era of highly transmissible Omicron sub-variants, any protection offered by the vaccine against the transmission of infection from one person to another is expected to be extremely limited. Therefore, the indirect benefits of vaccination, vaccinating an individual such as an unpaid carer in order to reduce the risk of severe disease in other people, are less evident now compared with previous years, and therefore unpaid carers were not eligible for a COVID-19 vaccination in autumn 2024.

In line with JCVI’s advice, the autumn 2025 programme is focused on targeted vaccination of the oldest adults, those aged 75 years old and over and residents in a care home for older adults, and individuals who are immunosuppressed. These are the two groups who continue to be at higher risk of serious disease, including mortality. Any unpaid carer who is eligible through age or immunosuppression for vaccination in this campaign is encouraged to take up the offer.

The Government’s policy on eligibility for vaccination programmes is based on advice from the independent scientific advisory committee, the Joint Committee on Vaccination and Immunisation (JCVI). For autumn 2025, the JCVI advised that COVID-19 vaccination be offered to:

• adults aged 75 years old and over;
• residents in care homes for older adults; and
• persons aged six months old and over who are immunosuppressed, as defined in the ‘immunosuppression’ section of tables three and four in the COVID-19 chapter of the UK Health Security Agency’s Green Book.

The eligibility of COVID-19 vaccines for unpaid carers in autumn 2025 is the same as it was in 2024 and has not changed this year. Unpaid carers are not eligible for COVID-19 vaccination in the national programme. If unpaid carers quality on other grounds, for example, if they are immunosuppressed, then they can come forward to get a vaccine.

The Government has accepted the JCVI’s advice for COVID-19 vaccine eligibility in autumn 2025.

The Government has recognised that, nationally, demand for assessments for attention deficit hyperactivity disorder (ADHD) has grown significantly in recent years and that people are experiencing severe delays accessing such assessments.

It is the responsibility of the integrated care boards (ICBs) in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to ADHD assessment and treatment, in line with relevant National Institute for Health and Care Excellence guidelines.

NHS England established an ADHD taskforce which brought together those with lived experience with experts from the NHS, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including in accessing services and support. An interim report was published on 20 June, with the final report expected later this year, and we will carefully consider its recommendations.

The NHS South Yorkshire ICB advises that the Sheffield Adult Autism and Neurodevelopmental Service is reviewing its diagnostic pathways and recruiting additional staff in order to improve efficiency within the service. The NHS South Yorkshire ICB has also commissioned the Adult Autism and ADHD Support Hub, delivered by the voluntary sector organisation, Mental Health Matters, to offer free support to autistic people and people with ADHD living in Sheffield. The hub provides a range of practical advice and information on areas such as confidence building, peer support, and wellbeing.

NHS England’s ADHD taskforce is looking at how support for people with ADHD can be improved and I look forward to reading their report when it is published.

Lord Darzi’s independent review of the National Health Service, published September 2024, highlighted the severe delays in access to attention deficit hyperactivity disorder (ADHD) assessments and that demand for assessments for ADHD has grown significantly in recent years.

It is the responsibility of the integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including ADHD assessments, in line with relevant National Institute for Health and Care Excellence guidelines.

NHS England has established an ADHD taskforce which is working to bring together those with lived experience with experts from the NHS, education, charity, and justice sectors to get a better understanding of the challenges affecting those with ADHD, including timely and equitable access to services and support, with the report expected in the summer.

In conjunction with the taskforce, NHS England has carried out detailed work to develop an ADHD data improvement plan to inform future service planning. NHS England has also captured examples from ICBs who are trialling innovative ways of delivering ADHD services, and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs.