Under the Care Act 2014, local authorities have the duty to shape their care market and to commission a range of high-quality, sustainable, and person-centred care and support services to meet the diverse needs of all local people. This includes encouraging a wide range of service provision to ensure that people, including those with sight loss, have a choice of appropriate services and equipment that maximises independence.

Although the Care Quality Commission (CQC) is not currently required to assess vision rehabilitation services as regulated activities under the Health and Social Care Act 2008, sensory services, including vision rehabilitation, do form part of the CQC’s overall assessment of local authorities’ delivery of adult social care.

CQC assessments identify local authorities’ strengths and areas for development, in their delivery of their duties under part 1 of the Care Act. This facilitates the sharing of good practice and helps us to target support where it is most needed. It may be helpful to know that the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement.

In 2024, the UK independent advisory Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) published its latest statement on aircraft cabin air quality following a request from the Department for Transport. This followed a COT statement published in 2007, and a position paper published in 2013.

Overall, the latest COT statement concluded that the concentrations of the chemical contaminants (organophosphates, volatile organic compounds including as mixtures, carbon monoxide and carbon dioxide) reported in aircraft cabin air are unlikely to cause adverse health effects in aircrew following acute or long-term exposures.

The 2024 statement on statement on aircraft cabin air quality is available at the following link:

https://cot.food.gov.uk/Statement%20on%20Aircraft%20Cabin%20Air%20Quality

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

This may involve commissioning general practices (GPs) or other providers, to whom GPs may refer patients, to provide ear wax removal services.

Manual ear syringing is no longer advised by NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP may then refer the patient into audiology services, which ICBs are responsible for commissioning.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

This may involve commissioning general practices (GPs) or other providers, to whom GPs may refer patients, to provide ear wax removal services.

Manual ear syringing is no longer advised by NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP may then refer the patient into audiology services, which ICBs are responsible for commissioning.

As hospices are independent, charitable organisations, the Department and NHS England do not collect data on the level of utilisation of hospices. Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that hospices also play in providing support to people at the end of life and their loved ones, as well as alleviating pressure on NHS services.

In December 2024, we announced that we were providing £100 million of capital funding for eligible adult and children’s hospices in England. This was split across two financial years, with hospices receiving £25 million to spend in 2024/25 and £75 million to spend in 2025/26.

I am pleased to say that we can now confirm we are providing a further £25 million in capital funding for hospices to spend in 2025/26.

Furthermore, children and young people’s hospices have received £26 million of revenue funding for 2025/26 and we are also providing £80 million of revenue funding for children and young people’s hospices over the next three financial years, from 2026/27 to 2028/29, giving them stability to plan ahead and focus on what matters most, caring for their patients.

We are in a challenging fiscal position across the board. At this time, we are not in a position to offer any additional funding beyond that outlined above. However, we are trying to support the hospice sector in other ways.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting integrated care boards 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 immediate changes to the skills thresholds outlined in the Immigration White Paper relate to roles below Regulated Qualifications Framework (RQF) level 6. Nurses meet the new skill threshold of RQF level 6 and in turn remain eligible for the Health and Care Worker visa.

The Government is committed to developing homegrown talent and giving opportunities to more people across the country to join our National Health Service. The 10 Year Workforce Plan will outline strategies for improving retention, productivity, training, and reducing attrition, thereby enhancing conditions for all staff while gradually reducing reliance on international recruitment, without diminishing the value of their contributions.

We acknowledge that the adult social care sector faces significant challenges in the recruitment and retention of the nursing workforce and we recognise the need for a strong emphasis on retaining nurses within adult social care, by supporting and valuing the workforce.

The Department continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool, and intelligence from key sector partners.

While the General Medical Council register contains data on the number of qualified general practitioners (GPs), the National Health Service is not the is not the sole employer of GPs. They may choose to undertake private work, to work in other settings outside of general practice, for example, prisons or army bases, or to work abroad. Since the NHS only collects data on GPs employed through the NHS, unemployment figures are not available.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.

International recruitment has played a valuable role in helping to grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.

International recruitment has played a valuable role in helping to grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

The Immigration and Nationality (Fees) (Amendment) Order 2025, laid on 21 January 2025, sets out increases to the fee maxima that applies to the Certificate of Sponsorship from £300 to £525. These changes were agreed via collective agreement. If fees increase as set out in the Explanatory Memorandum to this Order, an Impact Assessment will be produced by the Home Office.

International recruitment has played a valuable role in helping grow the adult social care workforce. The Government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and improve the retention of the domestic workforce. The Government is making available up to £3.7 billion of additional funding for social care authorities in 2025/26, which includes an £880 million increase in the Social Care Grant.

Adult social care is a central part of local government’s responsibilities. Decisions about the funding of all local government priorities will be taken in the round at the Spending Review.

We hugely value the critical role that general practitioners (GPs) play and are determined to address the issues they face by shifting the focus of the National Health Service beyond hospitals and into the community. The Government committed to recruiting over 1,000 recently qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to address GP unemployment and secure the future pipeline of GPs.

We are investing an additional £889 million through the GP contract to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.

Under recently announced changes to the GP contract in 2025/26, the ARRS will become more flexible to allow primary care networks (PCNs) to respond better to local workforce needs. The two ARRS pots will be combined to create a single pot for reimbursement of patient facing staff costs. There will be no restrictions on the number or type of staff covered, including GPs and practice nurses.

In a drive to recruit GPs via the ARRS and to bring back the family doctor, the salary element of the maximum reimbursement amount that PCNs can claim for GPs will be increased from £73,113 in 2024/25, the bottom of the salaried GP pay range, to £82,418, an uplift of £9,305 representing the lower quartile of the salaried GP pay range, as some GPs will be entering their second year in the scheme. Proportionate employer on-costs will also be included within the overall maximum reimbursement amount which PCNs will be able to claim.

Data on the number of unemployed GPs is not held centrally.

Primary care networks have been able to recruit newly qualified general practitioners (GPs) through the scheme since October 2024, with £82 million in funding provided in 2024/25. Information on the number of recently qualified GPs for which primary care networks are claiming reimbursement via the Additional Roles Reimbursement Scheme is currently being collated, but is not yet published. We are working to verify the data and establish its reliability, which is necessary before any dataset can be published.

We have made necessary decisions to fix the foundations of the public finances in the Autumn Budget. Resource spending for the Department will be £22.6 billion more in 2025/26 than in 2023/24, as part of the Spending Review settlement. The employers’ National Insurance rise will be implemented in April 2025.

We are investing an additional £889 million in general practice to reinforce the front door of the National Health Service, bringing total spend on the GP Contract to £13.2 billion in 2025/26. This is the biggest increase in over a decade.

The Additional Roles Reimbursement Scheme (ARRS) is subject to annual review as part of the consultation on the GP contract with professional representatives.

The consultation on the 2025/26 GP contract has now concluded and the General Practitioners Committee England has voted in support of the proposed changes for 25/26. Several changes have been confirmed to increase the flexibility of the ARRS. This includes general practitioners (GPs) and practice nurses included in the main ARRS funding pot, an uplift of the maximum reimbursable rate for GPs in the scheme, and no caps on the number of GPs that can be employed through the scheme.

The Carr-Hill formula aims to ensure that resources are directed to general practices (GPs) based on an estimate of their patient workload. It takes into account many factors under two groups, namely 'drivers of workload' and 'unavoidable costs', including additional needs related to morbidity and mortality, but it does not specifically address deprivation. Plans to review this funding formula may be revisited in future. However, any changes would need careful planning to ensure they do not threaten stability or cause financial uncertainty for GPs.

We are committed to ensuring that primary care medical services receive appropriate support and resources. We recently announced a proposed funding uplift for GPs for 2025/26 of £889 million. This is the largest uplift to GP funding since the beginning of the five-year framework and means a rising share of total National Health Service resources being directed towards GPs.

General practices (GPs) and other National Health Service organisations are encouraged to support patients to use online routes where this would be convenient for them, and there is work to improve the usability of digital tools so that they are accessible to larger numbers of patients. However, a choice of access routes should remain available.

As outlined in the GP Contract, digital services should be provided in addition to other channels for accessing GPs, such as in person visits, rather than as a replacement. Practice receptions should also remain open to ensure that those without access to a telephone or online services are not disadvantaged.

There are currently approximately 65 locally funded early support hubs in England offering early access mental health interventions to thousands of children and young people aged 11 to 25 years old, including those from low-income families.

The Department is running a £8 million Shared Outcomes Fund project throughout 2024/25 to boost and evaluate the impact of 24 of these existing early support hubs, including two in London.

In addition, we will roll out Young Futures hubs in every community. This national network is expected to bring local services together, deliver support for teenagers at risk of being drawn into crime or facing mental health challenges and, where appropriate, deliver universal youth provision. They will provide open access mental health support for children and young people in every community.

We will be working closely with colleagues across the Government to design Young Futures hubs, as well as engaging widely with young people and stakeholders to shape their service offer.