Shockat Adam

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.

In 2025/26 alone, this government plans to spend over £8 billion on early years entitlements and we have increased the early years pupil premium by over 45%. On top of this, we are providing further supplementary funding of £75 million for the Early Years Expansion Grant.

To set early years funding rates, we uplift the national average rate from the previous year taking into account cost pressures facing the sector, including forecasts of average earnings and inflation, and the National Living Wage. We use the early years national funding formulae (EYNFF) to distribute the early years entitlements budget to local authorities. The EYNFF includes a base rate for each child, which is the same minimum funding for every child no matter where they live or whether they have additional needs. This rate is based on the core costs of childcare provision and has been informed by the cost of childcare review.

To make sure we can account for the differences in costs across the country, such as on staffing and premises costs, we also apply an area cost adjustment for each area. This approach only increases funding, it never reduces the base rate or additional needs funding.

The average hourly funding rate provided for 3 and 4-year-olds since 2018 is as follows:

It is our ambition that all families have access to high-quality, affordable and flexible early education and care, giving every child the best start in life. This is key to the government’s Plan for Change, which starts with reaching the milestone of a record number of children being ready for school. That also means ensuring the sector is financially sustainable and confident as it continues to deliver entitlements and high-quality early years provision going forward.

In 2025/26 alone, this government plans to spend over £8 billion on early years entitlements and we have increased the early years pupil premium by over 45%. On top of this, we are providing further supplementary funding of £75 million for the Early Years Expansion Grant.

To set early years funding rates, we uplift the national average rate from the previous year taking into account cost pressures facing the sector, including forecasts of average earnings and inflation, and the National Living Wage. We use the early years national funding formulae (EYNFF) to distribute the early years entitlements budget to local authorities. The EYNFF includes a base rate for each child, which is the same minimum funding for every child no matter where they live or whether they have additional needs. This rate is based on the core costs of childcare provision and has been informed by the cost of childcare review.

To make sure we can account for the differences in costs across the country, such as on staffing and premises costs, we also apply an area cost adjustment for each area. This approach only increases funding, it never reduces the base rate or additional needs funding.

The average hourly funding rate provided for 3 and 4-year-olds since 2018 is as follows:

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

The government’s Plan for Change sets out a commitment to give children the best start in life, breaking the link between background and opportunity.

Ofsted publishes data on the numbers of all types of providers joining and leaving the sector each year. Some caution is required in using the numbers because, for example, a nursery may resign one registration and immediately register new provision. Please also note that this data was released under the previous government:

Note that from 2019/20, the numbers of annual joiners and leavers are calculated by comparing the beginning of the year to the end. Therefore, the numbers of providers joining and leaving from 2019/20 are not comparable with the figures up to 2018/19.

Ofsted’s most recent publication shows the number of places available increased by 12,100 (1%) between August 2023 and August 2024. The department’s projections on demand for places are not published by region but show that around half of local areas need to increase their capacity by between 10% and 20% to meet demand for September 2025, with the highest uplift being in some of the most disadvantaged areas.

In July 2024, this government established the independent Curriculum and Assessment Review, covering ages 5 to 18, chaired by Professor Becky Francis CBE.

The Review seeks to deliver a rich, broad, inclusive and innovative curriculum that readies young people for life and work. This includes creative subjects such as art, music and drama, as well as skills for life and work.

On 18 March, the Review published a well-evidenced, clear interim report, which sets out its interim findings and confirms the key areas for further work.

The final report with recommendations will be published this autumn, along with the government’s response. The Review’s recommendations will inform changes to the current system.

The Durham Commission report published in 2019 set out a number of recommendations, and some were taken forward by the previous government, Arts Council England and others.

This includes the ‘Creativity Collaboratives’ programme established by Arts Council England in 2021 to test innovative practices in teaching for creativity.

I refer the hon. Member for Leicester South to the answer of 13 May 2025 to Question 49523.

Schools are free to decide which events to commemorate and what activities to put in place to support pupils’ understanding of significant events and particular months or days dedicated to specific historical events, such as the International Day of Reflection and Commemoration of the 1995 Genocide in Srebrenica.

Schools also have the opportunity to mark such events though the curriculum, and to teach about the Srebrenica Genocide, for example, through subjects such as history and citizenship.

Within schools, statutory relationships, sex and health education (RSHE) supports children and young people to make informed decisions in relation to their mental wellbeing and online behaviour. The RSHE statutory guidance is clear that children and young people should be taught about the risks related to gambling including the accumulation of debt, how advertising and information is targeted at them and how to be a discerning consumer of information online.

These subjects support children and young people to develop self-control and their ability to self-regulate, as well as providing strategies for doing so.

Young people attending further education (FE) colleges, take part in regular tutor sessions that are devoted to their personal development. This includes financial education and the informed use of money where the dangers of gambling can be discussed. The department continues to work closely with the FE sector to promote and support providers to develop and implement a whole college approach to mental health and wellbeing. This includes establishing Mental Health Support Teams in schools and colleges to provide early intervention for students experiencing mild to moderate mental health issues.

Integrated care boards (ICBs) are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

ICBs already commission National Health Service sight testing services through high street optical practices. Regular sight tests, whether provided by the NHS or privately, play a vital role in the early detection of sight threatening eye conditions.

ICBs can also commission enhanced eye care services from high street optical practices, including minor and urgent eye care services and glaucoma referral refinement services. These services further support the identification and management of eye conditions to prevent avoidable sight loss.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

Integrated care boards are responsible for assessing the health needs of their population and for commissioning primary and secondary eye care services to meet them.

Over the last 12 months I have met with a number of representatives across the eye care sector including The Optometric Fees Negotiating Committee, The Eyes Have It Partnership, as well as members of the All Party Parliamentary Group for Eye Health and Visual impairment, which included the Hon. Member for Leicester South, to discuss primary eye care services. Officials in the Department also regularly meet with optometry stakeholders.

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

The 10-Year Health Plan sets out to create a new model of care. It sets out to reinvent the National Health Service through three shifts, from hospital to community, from analogue to digital, and from sickness to prevention. At the core of the plan is the development of the provision of care closer to home through, through neighbourhood health services. The plan is clear that we need to expand the local services that are offered, many of which are currently provided by the four sets of primary care contractors alongside community health services. It will be imperative therefore that we work with all these sectors, both nationally and locally, as plans develop. We have already started that process. As part of the work to develop a 10-Year Health Plan, we ran a significant public engagement process to collect views and ideas from across the country, on order to help inform the plan. This engagement will continue as we seek to work with stakeholders from across primary care to deliver a service fit for the future.

NHS.net, formally NHSmail, provides licences for optometry practices in England, specifically for General Ophthalmic Services contractors with 10 or fewer sites. Eligible practices can receive one shared mailbox and up to three individual NHS.net accounts per site, enabling the secure communication of patient data. NHS.net also provides secure communication to other commissioned partners delivering healthcare across pharmacy, dentistry, social care, and other neighbourhood community providers.

NHS England has been supporting the integrated care boards (ICBs) with the roll out of the special schools’ sight testing service. NHS England hosted a series of webinars to talk ICBs through the nationally developed service specifications. Each ICB received a comprehensive information pack outlining the level of interest expressed by both educational settings and service providers.

NHS England has established reporting on ICB progress in commissioning services, and all have indicated that they are either actively commissioning services, preparing for procurement activities, or planning engagement with local schools. Whilst services are being commissioned, the proof of concept contractors continue to provide services across 83 special schools.

The National Institute for Health and Care Excellence (NICE) has been monitoring the impact of the severity modifier since it was implemented in 2022. Data up to March 2025 shows that the proportion of positive cancer recommendations is higher (85%) than with the end-of-life modifier it replaced (75%) and the proportion of positive recommendations for advanced cancer treatments is also higher (81% compared to 69%).

Since January 2022, NICE has recommended all but one of the treatments for breast cancer that it has assessed, including treatments for advanced breast cancer (such as Truqap and Korserdu), which are now available to eligible National Health Service patients.

The severity modifier is therefore working as intended and there are currently no plans to adjust or change it in the near future. However, NICE has commissioned research on people’s attitudes to how the severity modifier should be applied that will inform future reviews of NICE’s methods.

The Government announced in the 10 Year Infrastructure Strategy document on 19 June 2025, as well as in the 10-Year Health plan published on 3 July 2025, that it will explore the feasibility of using new Public Private Partnerships (PPPs) to deliver certain types of primary and community health infrastructure, including neighbourhood health centres. The business case is being co-developed by the Department of Health and Social Care and the National Infrastructure and Service Transformation Authority. The decision on whether to proceed with the use of PPPs for neighbourhood health centres will be made by HM Treasury and relevant ministers by the 2025 Autumn Budget.

The Government’s Eatwell Guide already advises that people should eat more fruit, vegetables, and wholegrain or higher-fibre foods, as well as less processed meat, and less food and drink that is high in sugar, calories, saturated fat, and salt.

The Eatwell Guide principles are communicated through a variety of channels, including the NHS.UK website and Government social marketing campaigns. For example, the Better Health Healthier Families website and the Healthy Steps email programme, which aims to help families with primary aged children in England to eat well and move more.

The range of actions that have already been taken to create a healthier environment to help children reduce their consumption of processed foods that are high in energy, saturated fat, salt, and free sugars, and to improve access to affordable, minimally processed foods, include:

- the Healthy Start scheme, which supported over 361,000 people in April 2025;

- the Nursery Milk Scheme, which provides a reimbursement to childcare providers in England and Wales for a daily 1/3 pint portion of milk to children and babies; and

- the School Fruit and Vegetable Scheme, which provides approximately 2.2 million children in Key Stage 1 with a portion of fresh fruit or vegetables per day at school.

In relation to foods and drinks high in calories, saturated fat, salt, and free sugars, work on our commitments is progressing through:

- implementing the television and online advertising restrictions for less healthy food or drink;

- consulting on plans to ban the sale of high-caffeine energy drinks to children under 16 years old; and

- giving local authorities stronger, clearer powers to block new fast-food outlets near schools and where young people congregate.

National Health Service planning guidance for 2025/26 includes a focus on improving care for people with a learning disability and autistic people and contains the objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people in 2025/26. As part of operational planning, each integrated care board (ICB) is expected to: reduce the number of adults with a learning disability, including those who may also be autistic, in mental health inpatient care by 20% from a 31 March 2024 baseline by 31 March 2026; and reduce the number of autistic adults, with no learning disability, in mental health inpatient care by 20% from a 31 March 2024 baseline by 31 March 2026.

The baseline is from Assuring Transformation data and was extracted from 31 March 2024. The expectation is that ICBs will have been working towards achieving a 10% reduction from the 31 March 2024 baseline by 31 March 2025 and will build on this during 2025/26. They are therefore expected to achieve a 20% reduction from the 31 March 2024 baseline by 31 March 2026.

National Health Service planning guidance for 2025/26 includes a focus on improving care for people with a learning disability and autistic people and contains the objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people in 2025/26. The baselines being used to measure progress against operational planning guidance are: adults with a learning disability, including those who may also be autistic, in mental health inpatient care as of 31 March 2024, based on Assuring Transformation data extracted from 31 March 2024; and adults who are autistic, with no learning disability, in mental health inpatient care as of 31 March 2024, based on Assuring Transformation data extracted from 31 March 2024.

The expectation is that integrated care boards will have been working towards achieving a 10% reduction from the 31 March 2024 baseline by 31 March 2025, and will build on this during 2025/26. They are therefore expected to achieve a 20% reduction from the 31 March 2024 baseline by 31 March 2026.

The best treatment options for any individual patient will be decided by the treating clinician in discussion with the patient, taking into account relevant National Institute for Health and Care Excellence (NICE) guidance. NICE guidance on trabecular stent bypass microsurgery for open-angle glaucoma sets out that trabecular bypass surgery can be combined with a cataract operation and has shown its ability to reduce intraocular pressure.

Regular sight tests play a crucial role in the early detection of glaucoma, which is often symptomless in the early stages. Free National Health Service sight tests are available for many, including individuals diagnosed with glaucoma or those aged 40 years old and over with a close family history of glaucoma. Patients with suspected glaucoma will be referred for further investigation, any clinically necessary treatment, and ongoing monitoring, which can delay its progression.

NHS England has been testing how IT connectivity between primary and secondary eye care services and the development of a single point of access could improve the referral and triage of patients, reducing the time from referral to treatment. It could also allow for more patients to be managed closer to home, within community optometry. This could benefit all patients with eye care needs, including those with suspected or diagnosed glaucoma.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to preventing and managing conditions such as glaucoma in all parts of the country. More tests and scans delivered in the community and better joint working between services will support the management of conditions, including glaucoma, closer to home.

The plan will draw directly from the extensive engagement we have undertaken with the public, patients, and staff, including in the eye care sector. We are in the final stages of working on the plan and will publish it shortly.

The National Institute for Health and Care Excellence will continue to play a crucial role in evaluating new medicines, medical devices, and other technologies, to determine their clinical and cost-effectiveness, before recommending them for NHS use.

The 10-Year Health Plan will deliver the three big shifts our National Health Service needs to be fit for the future: from hospital to community; from analogue to digital; and from sickness to prevention. All of these are relevant to preventing and managing conditions such as glaucoma in all parts of the country. More tests and scans delivered in the community and better joint working between services will support the management of conditions, including glaucoma, closer to home.

The plan will draw directly from the extensive engagement we have undertaken with the public, patients, and staff, including in the eye care sector. We are in the final stages of working on the plan and will publish it shortly.

The National Institute for Health and Care Excellence will continue to play a crucial role in evaluating new medicines, medical devices, and other technologies, to determine their clinical and cost-effectiveness, before recommending them for NHS use.

The Government is delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres to bring together community, crisis, and inpatient care; these are open 24 hours a day, seven days a week.

NHS England’s Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity

We are also improving data quality so we can support providers in understanding demand across their areas. Since July 2023, NHS England has included waiting times metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication to help services target the longest waits.

Our 10-Year Health Plan will inform the future vision and delivery plan for mental health services in England. Earlier intervention remains a key focus of the plan with the aim of reducing pressure on mental health services.