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 he plans to introduce national waiting-time standards for ADHD and autism assessments for under-18s; and what progress NHS England has made in improving the (a) collection and (b) publication of data on waiting times for (i) ADHD and (ii) autism assessments.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) recommends a maximum waiting time of 13 weeks between a referral for an autism assessment and a first appointment. There is no wait standard for referral for an autism assessment to receiving a diagnosis of autism, and NICE guidelines for attention deficit hyperactivity disorder (ADHD) diagnosis and management do not recommend a maximum waiting time standard from referral for an assessment of ADHD to the assessment being provided.
NICE guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with stakeholders. They are not mandatory, but National Health Service commissioners are expected to take them fully into account in designing services to meet the needs of their local populations.
The Medium-Term Planning Framework, published 24 October, was explicit that integrated care boards (ICBs) and providers are expected to optimise existing resources to reduce long waits for autism and ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published.
NHS England publishes quarterly statistical data on waiting times within autism diagnostic pathways, which remain under constant review. This data is available at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/autism-statistics
For the first time, NHS England published management information on ADHD assessment waiting times at a national level on 29 May 2025 as part of its ADHD data improvement plan, and it has also released technical guidance to ICBs to improve the recording of ADHD data, with a view to improving the quality of ADHD waits and diagnosis data as well as publishing more localised data in future.
The most recent data, published in August 2025 and is available on the NHS England website, at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/mi-adhd/august-2025
Data in this publication is sourced from a number of existing NHS England datasets, and the publication is known to contain a number of data quality issues, further details of which can be found at the following link:
https://digital.nhs.uk/data-and-information/publications/statistical/mi-adhd/supporting-information
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 improve support for adults with cerebral palsy.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to ensuring that people living with cerebral palsy have access to appropriate support and services throughout their lives, enabling them to fulfil their potential and lead healthy, productive lives.
The National Institute for Health and Care Excellence (NICE) has published a guideline for adults with cerebral palsy, code NG119. The guideline recommends regular reviews of clinical and functional needs, clear care pathways, and access to multi-disciplinary teams and specialist neurology services. The guideline is available at the following link:
https://www.nice.org.uk/guidance/ng119
The 10-Year Health Plan sets out a vision for a health and care system that delivers more personalised, integrated, and proactive care for people with long-term and complex conditions, including cerebral palsy. By 2027, 95% of people with complex needs should have an agreed personal care plan. These will promote shared decision-making and access to personal health budgets, giving individuals more choice and control over therapies, equipment, and support tailored to their needs. Additionally, integrated neighbourhood health teams will bring together professionals across disciplines to deliver joined-up care for people with cerebral palsy.
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 he is taking to ensure that people who need it have access to palliative care services in Harpenden and Berkhamsted constituency.
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. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs, including the Hertfordshire and West Essex ICB, the Surrey Heartlands ICB, and the Frimley ICB, must work to ensure that there is sufficient provision of care services to meet the needs of their local populations.
NHS England has also developed a palliative care and end of life care dashboard. The dashboard helps commissioners understand the palliative care and end of life care needs of their local population, including the ability to filter the available information, such as by deprivation or ethnicity, enabling ICBs to put plans in place to address and track the improvement of health inequalities, and ensure that funding is distributed fairly, based on prevalence.
The Department and NHS England are currently working at pace to develop plans on how best to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.
Additionally, through the National Institute for Health and Care Research, the Department has invested £3 million in a Policy Research Unit in Palliative and End of Life Care. This unit is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.
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 he is taking to ensure that hospice contracts reflect the (a) cost of the services they provide and (b) needs of the local population in Harpenden and Berkhamsted constituency.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs, including the NHS Hertfordshire and West Essex ICB, which covers the Harpenden and Berkhamsted constituency, in this duty, NHS England has published statutory guidance and service specifications. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place.
Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations also play.
The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area. It is important to note that hospices, like the NHS, provide both specialist and generalist palliative care and end of life care. Not all patients will require specialist palliative care.
The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10- Year Health Plan.
Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.
We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via ICBs. This amounts to approximately £80 million over the next three years.
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 plans he has to ensure adequate financial support for the full range of specialist palliative care services provided by hospices.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs, including the NHS Hertfordshire and West Essex ICB, which covers the Harpenden and Berkhamsted constituency, in this duty, NHS England has published statutory guidance and service specifications. NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place.
Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations also play.
The amount of funding charitable hospices receive varies by ICB area, and will, in part, be dependent on the breadth of palliative care, including specialist palliative care, and end of life care provision within each ICB catchment area. It is important to note that hospices, like the NHS, provide both specialist and generalist palliative care and end of life care. Not all patients will require specialist palliative care.
The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10- Year Health Plan.
Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.
We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. I am pleased to confirm the continuation of circa £26 million, adjusted for inflation, for the next three financial years, 2026/27 to 2028/29 inclusive, to be distributed again via ICBs. This amounts to approximately £80 million over the next three years.
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 ensure that patients with postural orthostatic tachycardia syndrome have access to (a) specialist (i) clinicians, (ii) nurses, (iii) physiotherapists, (iv) occupational therapists, (v) dieticians and (vi) clinical psychologists and (b) (A) equipment and (B) clinic space in Harpenden and Berkhamsted constituency.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Services for people with postural tachycardia syndrome (PoTS) are commissioned locally by integrated care boards (ICBs). ICBs have a statutory responsibility to provide a health service to the local population, subject to local prioritisation and funding, which includes access to specialist medical services for people with PoTS as appropriate.
The treatment of patients with PoTS in the Harpenden and Berkhamsted constituency area is managed on an individual, case-by-case basis. A multi-disciplinary team approach has been adopted, involving specialists such as physiotherapists, cardiologists, and neurologists. Patients are referred into specialist centres in London if their diagnosis or treatment requires a more specialist approach or facilities.
More widely, the Government is committed to publishing a 10 Year Workforce Plan which will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it, including for patients with PoTS.
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 reduce waiting times for neurology outpatient appointments; and what plans are in place to ensure timely access to neurological care for all patients.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to delivering the National Health Service constitutional standard that 92% of patients to wait no longer than 18 weeks from referral to treatment by March 2029. This includes patients waiting for neurology care.
As of August 2025, the neurology waiting list stands at 226,432, a reduction of 4.3% since August 2024. Since coming into office we have delivered 5.2 million additional appointments, including for neurology care, in part by rolling out reforms outlined in the Elective Reform Plan (ERP). These reforms include broadening access to outpatient care, through virtual and group consultations, and minimising missed appointments.
We have also expanded the Advice and Guidance scheme, which helps to ensure that patients get care in the right place and only see a specialist if it’s really necessary, freeing up capacity in secondary care for those who need it, including certain patients with neurology conditions or symptoms. The latest data, which is subject to change, shows this has resulted in 589,336 requests being “diverted” since April 2025, a 4.3% increase compared to the same period in 2024.
The 10-Year Health Plan builds on the ERP with a more sustainable vision for elective care where two-thirds of outpatient care is moved to community settings or delivered remotely, rather than in hospitals. Patients' access to specialists, including neurologists, will be improved by providing this specialist care in the community where possible and increasing digital access to specialists through the NHS app where it’s more convenient for patients. The recently published Medium Term Planning Framework outlines targets for the NHS from 2026/27 to 2028/29 to deliver the 10-Year Health Plan’s ambitions, including giving patients more control over their follow up care to reduce unnecessary appointments and expanding Advice and Guidance, thereby freeing up appointments and reducing long waits, including for neurology 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 steps his Department is taking to ensure the availability of health play (a) services and (b) professionals for children.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government is committed to raising the healthiest generation of children ever, which includes ensuring that children receive the appropriate care and support whenever they need it.
In support of this commitment, NHS England and Starlight, a national charity for children’s play in healthcare, co-published the Play Well Toolkit in June 2025. The toolkit recognises the important role of health play teams and provides important guidance on best practice, enabling these teams to deliver child-friendly care. NHS England is promoting the Play Well toolkit to managers of health play services across a wide range of settings, including community clinics, emergency departments, children’s hospices, and acute paediatric wards.
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 tackle ensure that children have access to health play services in (a) children's hospitals and (b) children's wards in district general hospitals.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department recognises the importance of supporting and maintaining children’s right to play in healthcare settings, because games and active play in all settings build social skills and promote children’s well-being.
To support this, in June 2025 NHS England and Starlight, a national charity for children’s play in healthcare, co-published the Play Well Toolkit. The toolkit provides guidance on best practice, and includes a checklist to support the auditing, monitoring, and evaluation of services. NHS England is promoting the Play Well toolkit to managers of health play services across a wide range of settings, including community clinics, emergency departments, children’s hospices, and acute paediatric wards.
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 discussions he has had with NHS England on including postural orthostatic tachycardia syndrome training in junior doctor specialty training programmes.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No discussions have been held. The curricula for postgraduate training are set by the Academy of Medical Royal Colleges for foundation training, and by individual royal colleges and faculties for specialty training. The General Medical Council approves curricula and assessment systems for each training programme. Whilst not all curricula may necessarily highlight a specific condition, they all nevertheless emphasize the skills and approaches a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.