Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 potential merits of funding the full cost of specialist palliative care delivered by hospices.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.
The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable ICBs to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care.
Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. We will consider contracting and commissioning arrangements as part of our MSF. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.
The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.
Hospices provide both core and specialist palliative care. Whilst acknowledging that not everyone will need specialist palliative care, we must ensure is that there is equitable and timely access to these services, whether they are provided by hospices or the National Health Service.
While no specific assessment has been made of the cost of changes in the levels of funding to hospices on the wider healthcare system, as part of our 10-Year Health Plan, the Government will shift the focus of healthcare out of the hospital and into the community. We recognise that it is vital to include palliative care and end-of-life care, including hospices, in this shift.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 cost of changes in the levels of funding to hospices on the wider healthcare system.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.
The Government is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England. The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable ICBs to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care.
Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. We will consider contracting and commissioning arrangements as part of our MSF. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.
The recently published Strategic Commissioning Framework and Medium-Term Planning Guidance also make clear the expectations that ICBs should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.
Hospices provide both core and specialist palliative care. Whilst acknowledging that not everyone will need specialist palliative care, we must ensure is that there is equitable and timely access to these services, whether they are provided by hospices or the National Health Service.
While no specific assessment has been made of the cost of changes in the levels of funding to hospices on the wider healthcare system, as part of our 10-Year Health Plan, the Government will shift the focus of healthcare out of the hospital and into the community. We recognise that it is vital to include palliative care and end-of-life care, including hospices, in this shift.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to introduce a statutory right to access free period products.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government recognises the importance of women and girls being able to access the care they need for their reproductive health, including period products.
We know that poverty doesn’t recognise gender, and that women and girls may suffer given the cost of period products. However, we know that period poverty reflects wider cost-of-living pressures, which is why the Government is tackling the root causes of poverty, through measures to make work pay, boosting the living wage, and investing in public services, so no one has to go without the essentials.
There are a number of schemes across the Government which ensure that those who are most vulnerable can access the products they need. The Department for Education’s Period Products scheme launched in 2020 and provides free period products to girls and women in their place of study so that nobody misses out on education because of their period. Similarly, all women and girls being cared for by the National Health Service are entitled to be given, upon request, appropriate period products free of charge.
We are also taking steps to ensure that products are as affordable as possible, as the tax on period products has been zero-rated since 2021, and in 2023 this was extended to include reusable period underwear.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 potential impact of reductions in local authority public health nursing contracts on prevention and community-based care.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Decisions related to public health nursing contracts are taken at a local level.
Public health nursing has been funded by local authorities since 2015 through the Public Health Grant. We increased the Public Health Grant by £224 million this year, 2025/26, to support local authorities to deliver public health services. We will continue to invest in local authorities' vital public health work, providing over £13.4 billion, a 5.6% cash increase, over the next three years through a consolidated ringfenced Public Health Grant. This is the first three-year public health settlement in a decade, giving local authorities far greater certainty over their future funding and supporting their ability to plan ahead.
We have refreshed guidance for the Healthy Child Programme to strengthen service delivery and promote consistency in the quality of public health nursing across the country. This guidance is due for publication in early 2026.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 potential impact of Agenda for Change mileage reimbursement rates, including the change to the rate for travelling over 3,500 miles annually, on the (a) recruitment and (b) retention of community-based NHS staff.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
This specific assessment has not been made. As set out in the NHS Terms and Conditions of Service Handbook, which is maintained by the NHS Staff Council, mileage reimbursement rates are reviewed twice a year in April and November.
The outcome of the November 2025 review resulted in reimbursement rates reducing due to sustained decreases in fuel prices for the 12-month period ending in October 2025. Reimbursement rates dropped to 56 pence per mile for the first 3,500 miles claimed before dropping to 21 pence per mile thereafter. The revised rates apply to mileage incurred from 1 January 2026 onwards.
These changes apply to all staff directly employed in England under Agenda for Change terms and conditions and Resident Doctors. There are no specific rates for community staff.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the average waiting time is for paediatric referrals in (a) East and North Hertfordshire NHS Trust, (b) Hertfordshire and West Essex ICB and (c) England; and what steps his Department is taking to reduce paediatric referral backlogs.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The median average waiting time for paediatric referrals for those that are currently on the referral to treatment waiting list is:
- 8.7 weeks for the East and North Hertfordshire NHS Trust;
- 8.7 weeks for the Hertfordshire and West Essex Integrated Care Board (ICB); and
- 9.9 weeks for England.
Our Elective Reform Plan (ERP), published in January 2025, sets out how the National Health Service will reform elective care services and meet the 18-week referral to treatment standard for all patients, including children and young people, by March 2029. As a first step to achieving this, we exceeded our pledge to deliver an extra two million operations, scans, and appointments in our first year of Government, delivering 5.2 million more appointments.
We have made it easier to monitor elective waiting times for children and young people by publishing new demographic data as part of monthly inequalities statistical releases. This is a big step forward in improving the transparency of waiting times and will provide accountability for children’s elective waiting lists.
The ERP outlined several commitments specifically in relation to children and young people including that ICBs and providers should ensure interventions are in place to reduce disparities for groups who face additional waiting list challenges, and that primary and secondary care clinicians are encouraged to improve digital referral functionality by including data that enables better prioritisation.
In addition, the clinically led Getting It Right First Time Children and Young people programme continues to work with providers to ensure they are implementing best practice to improve children’s outcomes and waiting times across all medical and surgical specialities.
Lastly, dedicated paediatric surgery days are being introduced across England, using existing NHS estate in day surgery or hub settings, to boost surgical activity for children and young people. We are also making the most of surgical hubs to deliver better outcomes for children, through promoting greater paediatric ear, nose, and throat access. Surgical hubs will play a key role in delivering this increased activity and ensuring timely access to planned care.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 potential merits of enabling children waiting over 26 weeks for a paediatric appointment to be seen by alternative NHS-commissioned providers.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Patients in England have a right to request their local integrated care board (ICB) find an alternative provider when they have been waiting, or expect to wait, over 18 weeks to begin treatment for consultant-led care.
ICBs are required to take all reasonable steps to ensure the patient is offered an appointment with a clinically appropriate alternative provider with whom an ICB or NHS England has an NHS Standard Contract for the relevant service, who can start their treatment more quickly. Further information is available on the NHS Choice Framework at the following link:
https://www.gov.uk/government/publications/the-nhs-choice-framework/
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
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 provide support or funding to NHS Trusts with paediatric waiting times exceeding 26 weeks.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government’s ambition is to restore performance against the NHS Constitutional standard, which requires 92% of patients to start consultant-led treatment within 18 weeks.
All waiting lists are subject to clinical prioritisation at a local level. The National Health Service triages patients waiting for elective care, including surgeries, ensuring the order in which patients are seen reflects clinical judgement on need as well as taking into account overall wait time.
The Spending Review 2025 has prioritised health, with record investment in the health and social care system, including investment in elective services. Through the Spending Review, the Government announced that NHS day to day spending will increase by £29 billion in real terms by 2028/29 compared to 2023/24.
The Department recognises the impact of long waits on children and young people and is committed to reducing paediatric waiting times.
Through the Elective Recovery Plan, we have invested in additional capacity, including surgical hubs, community diagnostic centres, and increased use of the independent sector to support challenged trusts.
Targeted support is provided via Getting It Right First Time and specialty-specific improvement programmes, including paediatric ear, nose, and throat, and ophthalmology. National planning guidance sets expectations for systems to prioritise clinically urgent cases and those at risk of deterioration.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many children have waited more than (a) 26 and (b) 40 weeks for an initial paediatric referral triage in the most recent 12-month period for which data is available.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
We do not hold data on how many children have waited more than 26 and 40 weeks for an initial paediatric referral triage in the most recent 12-month period.
Published referral to treatment data covers the period on waiting time from referral to first definitive treatment.
Asked by: Victoria Collins (Liberal Democrat - Harpenden and Berkhamsted)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what guidance his Department has issued to Integrated Care Boards on clinically prioritising children whose symptoms are deteriorating while awaiting paediatric referral allocation.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to ensuring that patient outcomes will be at the heart of building a National Health Service that is fit for the future.
National planning guidance sets expectations for systems to prioritise clinically urgent cases and those at risk of deterioration. The NHS triages patients waiting for elective care at a local level, ensuring the order in which patients are seen reflects clinical judgement on need as well as taking into account overall wait time.
We have committed to ensuring that integrated care boards and providers have interventions in place to reduce disparities for groups who face additional waiting list challenges, and primary and secondary care clinicians are to improve e-RS functionality, a national digital platform for referring patients into elective care, by including data to enable better prioritisation of children and young people.
The clinically led Getting It Right First Time children and young people programme continue to work with providers to ensure they are implementing best practice to improve children’s outcomes and waiting times across all medical and surgical specialities.