Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase the number of consultants in (a) Lincolnshire NHS Trust and (b) other (i) rural and (ii) semi-rural areas; and if he will review (A) funding allocations and (B) workforce planning to ensure urgent cases are seen in a clinically appropriate timeframe.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
We will publish a 10 Year Workforce Plan to create a workforce ready to deliver a transformed service. They will be more empowered, more flexible, and more fulfilled. We will ensure the National Health Service has the right people in the right places, with the right skills to deliver the best care for patients, when they need it.
Doctors are more likely to settle and practice in the areas they train. We will work with the university and college sector to ensure we train and provide the staff, technology, and infrastructure the NHS needs to care for patients across our communities, including in rural and semi-rural areas such as Lincolnshire.
NHS England regularly keeps its funding allocations under review, and as set out in our recently published 10-Year Health Plan, we will break the old, short-term cycle of planning, and will ask all organisations to prepare robust and realistic five-year plans. Every organisation will be required to continue to refresh their plans over the medium term.
Decisions about recruitment in individual NHS trusts are a matter for those trusts, who manage this at a local level to ensure they have the staff they need to deliver safe and effective care.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the adequacy of the (a) availability and (b) timeliness of end-of-life palliative care support in Boston and Skegness constituency; and what steps he is taking to ensure that terminally ill patients fast-tracked due to a prognosis of fewer than 12 weeks to live receive appropriate physical and social care at home without having to wait until their final four weeks of life.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Palliative care services are included in the list of services an integrated care board (ICB) must commission, including Lincolnshire ICB, which covers the Boston and Skegness constituency. This promotes a more consistent national approach and supports commissioners in prioritising palliative and end of life care. ICBs are responsible for the commissioning of palliative and end of life care services, to meet the needs of their local populations.
To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance requires ICBs to work to ensure that there is sufficient provision of palliative and end of life care services to meet the needs of their local populations.
Additionally, the Lincolnshire ICB area benefits from a single palliative point of access that operates 24 hours a day, seven days a week: a single phone number, facilitated by specialist palliative nurses and the urgent and emergency care clinical assessment service, through which patients, families, carers and professionals can access care that is co-ordinated and delivered locally.
NHS Continuing Healthcare (CHC) is a package of National Health Service-funded ongoing health and social care for adults with the highest levels of complex, intense or unpredictable needs that have arisen as a result of disability, accident or illness.
Lincolnshire ICB’s policy for fast-track CHC funding does not set out a timeframe for applications based on the number of weeks of prognosis, but it is based on the narrative within the National Framework for NHS CHC of “rapidly deteriorating and entering end phase of life”. The CHC team works seven days a week to ensure fast-track applications are processed in a timely manner.
There is a dedicated CHC End of Life Case Manager for Boston and Skegness, who ensures people’s packages of care are appropriate and meeting the needs of the individual throughout their time they are in receipt of fast-track funding. Lincolnshire ICB has a contract in place with a single provider for Boston and Skegness, which ensures packages of care are arranged and delivered in a timely manner.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the adequacy of access to spinal services for patients in Boston and Skegness constituency; and what steps he is taking to ensure that residents can access (a) timely and (b) geographically appropriate spinal care.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The local acute trust in Lincolnshire, United Lincolnshire Teaching Hospitals NHS Trust (ULTH), does not have a spinal service. Emergency services take non-complex patients with potential spinal issues to the closest accident and emergency within Lincolnshire to be treated or stabilised, but if the patient is assessed at scene as having a spinal injury they will be transported directly to the Tertiary Centre at Nottingham University Hospital (NUH). NUH also provides a spinal consultant who supports ULTH on a weekly basis.
General practitioners in the Skegness and Boston area can refer patients to a local spinal assessment service which completes a full assessment of the patient’s condition with appropriate diagnostics. There are then two pathways for spinal services based on clinical need. Non-complex patients will be offered choice of local acute services and complex patients are offered a choice of the tertiary centres at NUH & Sheffield.
NHS England’s Midlands Regional Team has developed and implemented a network model of care for spinal cord injury (SCI) patients. Specialist clinicians in SCI provide acute care, intervention and training including outreach to local hospitals for patients who need SCI rehabilitation whilst they are waiting for a bed at a specialist SCI centre. SCI rehabilitation for Lincolnshire patients is primarily delivered via the specialist SCI centre in Sheffield. For Lincolnshire, NHS England has recognised that there is a significant clinical gap in these patients being managed locally whilst waiting for a specialist SCI rehabilitation bed. NHS England has allocated funding as part of the Network Model of Care for a post to be based at Lincoln Country Hospital to provide specialist support for Lincolnshire residents. Currently, this post is vacant, but NHS England and the trust are working towards successful recruitment.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether NHS England supports the policy of excluding children from community health services on the basis of school type; and what assessment he has made of the merits of such a policy.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
There is no policy that excludes children from community health services on the basis of school type. The National Health Service is free at the point of use and provides care to anyone who need it based on clinical need.
NHS occupational therapy services are provided for all children with an education, health and care plan (EHCP). For those without an EHCP, some schools provide on-site NHS occupational therapy.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps the Department is taking to (a) improve value for money, (b) prevent profiteering, (c) remove conflicts of interest in referral practices and (d) otherwise improve (i) oversight and (ii) regulation of private companies delivering NHS-funded eye care.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
All National Health Service patients must receive safe and high-quality care, whether being treated by private providers or directly by the NHS. While the independent sector has a role to play in tackling the waiting list backlog, we will not tolerate any overpriced or sub-par care. We will also not tolerate any distortion of patient choice, and the recently published Partnership Agreement between NHS England and the Independent Healthcare Providers Network commits to ending incentives that can lead to this, supporting equal access and genuine choice for all patients. We are now working together to deliver on this.
Improving value for money is a priority across all NHS pathways, not just in eyecare. This has been emphasised in various documents such as the Provider Selection Regime, the NHS Standard Contract and most importantly the Independent Sector Agreement, published in January 2025.
NHS-funded eye care is funded based on national prices and funded equitably across all providers with no opportunities to gain increased payment; prices are adjusted each year to reflect expected improvements in efficiency and are set to cover costs but not margins.
To prevent profiteering, providers are paid based on national prices, based in turn on the average cost of providing the service and adjusted to reflect the complexity of the procedure and the patient. This ensures that the provider is appropriately reimbursed, and they do not make excess profits by targeting the simplest cases.
NHS England expects all its providers to support patient choice and to act in accordance with the Law, with Good Practice and this is supported by the requirements of the NHS Standard Contract, the NHS Provider License, the General Ophthalmic Services contract and the Law itself. The NHS Standard Contract gives a useful overview of the Provider Selection Regime, which are the regulations the NHS must adhere to when commissioning health care services, including conflict of interest declarations.
Finally, private companies are commissioned and managed by integrated care boards under the terms of the NHS Standard Contract which applies the same standards of oversight and regulation as are applied to NHS providers.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that qualified (a) counsellors and (b) psychotherapists are (i) supported and (ii) distinguished from (A) psychiatric and (B) diagnostic services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
It is essential that all National Health Service staff, including counsellors and psychotherapists, can work in a supportive and compassionate environment that recognises and prioritises health and wellbeing. NHS England has a wide-ranging package of mental health and wellbeing support for all staff.
All healthcare professionals should follow the National Institute for Health and Care Excellence guidelines, which state that healthcare professionals directly involved in a patient's care should introduce themselves and explain their role to the patient.
Counsellors and psychotherapists are not statutorily regulated in the United Kingdom. Health professionals that are not subject to statutory regulation can join voluntary registers accredited by the Professional Standards Authority for Health and Social Care (PSA), such as the UK Council for Psychotherapy and the British Association for Counselling and Psychotherapy, who also provide support to their members.
The organisations accredited by the PSA are independent, representative bodies and as such, they do not fall under Government oversight, and therefore any decisions about the practice requirements for the professions they represent are a matter for those organisations and their members.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to review the Medical Certificate of Cause of Death process to speed up that process in (a) Boston and Skegness constituency and (b) the UK.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is monitoring the impact of the death certification reforms, which came into legal effect on 9 September 2024, through the Death Certification Strategic Board and a cross-Government data strategy group. Since the introduction of the reforms, the median time taken to register a death appears to have risen by two days, from seven days to nine days. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. Working with the Office for National Statistics, weekly data is now published on the time taken to register a death by region and also by setting. This is supporting NHS England and the Welsh administration to offer support and challenges.
The median time taken to register a death varies depending on the type of certification. Deaths certified by a doctor, that comprise approximately 80% of deaths registered each week, have typically had a median time to registration of seven days, though there can be variation at a local level. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.
The introduction of medical examiners is in part about making sure deaths are properly described and improving practice, but the impact on the bereaved is also central. The reforms aim to put the bereaved at the centre of the process, and the medical examiner’s office must offer a conversation with representatives of the deceased, so they can ask any questions they have about the death or raise any concerns. Ensuring the system is appropriately resourced and works for all those who interact with it is crucial, and something we will continue to monitor with NHS England.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the reasons for delays in emergency service response times in Boston and Skegness constituency; and what steps are being taken to improve response times.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Ambulance services in Boston and Skegness are provided by the East Midlands Ambulance Service NHS Trust, with responsibility for commissioning the services a matter for the local Lincolnshire Integrated Care Board. Any assessment of the specific local actions needed to improve response times should be undertaken and agreed locally by National Health Service organisations in the best interests of the local population and patients.
At a national level, the Government and NHS England are committed to improving ambulance response times. The NHS 2025/26 priorities and operational planning guidance sets national priorities, which include improving accident and emergency waiting times and ambulance response times compared to 2024/25.
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many staff in his Department are responsible for (a) processing and (b) responding to Freedom of Information Act requests; and if he will make an estimate of the annual cost to the public purse of this work.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department has a central team with a headcount of 13.8 full-time equivalent (FTE) staff who are responsible for managing Freedom of Information (FOI) requests and related appeals work. FOIs can be requested for any part of the Department's work. As such, various members of staff in the Department may at some point be involved with responding to an FOI request.
Most of these staff will carry out such work as part of their overall responsibilities. As such it is not feasible to determine, for the purposes of answering this question, precisely how many staff are responsible for processing and responding to FOI requests across the entire Department, or to provide estimates of the resulting costs.
Information on FOI volume and performance by department is published by the Cabinet Office, and is available at the following link:
https://www.gov.uk/government/collections/government-foi-statistics
Asked by: Richard Tice (Reform UK - Boston and Skegness)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has for the future of Torbay Hospital.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
My rt. Hon. Friend, the Secretary of State for Health and Social Care, set out a credible and deliverable plan for the new hospital schemes in the New Hospital Programme (NHP) on 20 January 2025, following the conclusion of the review of the NHP. The Plan for Implementation is available at the following link:
As confirmed in this publication, the scheme for Torbay Hospital is now part of Wave 2 of the NHP. Pre-construction activity, namely business case development and critical enabling works, is expected to continue from 2030, and construction of the main hospital build to commence between 2032 and 2034.