The Mental Capacity Act 2005 (MCA) is designed to protect and empower people who lack the mental capacity to make a decision themselves. It says that every person must be presumed to have capacity to make the decision in question unless it is established otherwise, and sets out a two-stage test to establish if a person can make specific decisions regarding their care and treatment. Capacity assessments are done locally, and data is not collated or held centrally on how many assessments are carried out.

The Deprivation of Liberty Safeguards (DoLS) is a procedure prescribed in law under the MCA when a person who lacks mental capacity to consent to their care or treatment is being deprived of their liberty in a care home or hospital in order to keep them safe from harm. DoLS assessments data is collated and published, the most recent data available is for 2023/24.

In 2023/24 there were 323,870 DoLS applications completed, 145,945 fully assessed, 15,270 closed partially assessed, 162,655 closed without assessments, and 123,790 not completed at year end.

The MCA code of practice gives guidance to people who work with, or care for, people who can’t make decisions for themselves, including when a mental capacity assessment should be carried out, and by whom. Government is clear that professionals applying the MCA are expected to keep up to date with guidance and caselaw, and to correctly use the principles within the act.

In October 2025 we announced our intention to run a joint consultation with the Ministry of Justice to consult on Liberty Protection Safeguards and an updated draft of the Code of Practice in 2026.

The Mental Capacity Act 2005 (MCA) is designed to protect and empower people who lack the mental capacity to make a decision themselves. It says that every person must be presumed to have capacity to make the decision in question unless it is established otherwise, and sets out a two-stage test to establish if a person can make specific decisions regarding their care and treatment. Capacity assessments are done locally, and data is not collated or held centrally on how many assessments are carried out.

The Deprivation of Liberty Safeguards (DoLS) is a procedure prescribed in law under the MCA when a person who lacks mental capacity to consent to their care or treatment is being deprived of their liberty in a care home or hospital in order to keep them safe from harm. DoLS assessments data is collated and published, the most recent data available is for 2023/24.

In 2023/24 there were 323,870 DoLS applications completed, 145,945 fully assessed, 15,270 closed partially assessed, 162,655 closed without assessments, and 123,790 not completed at year end.

The MCA code of practice gives guidance to people who work with, or care for, people who can’t make decisions for themselves, including when a mental capacity assessment should be carried out, and by whom. Government is clear that professionals applying the MCA are expected to keep up to date with guidance and caselaw, and to correctly use the principles within the act.

In October 2025 we announced our intention to run a joint consultation with the Ministry of Justice to consult on Liberty Protection Safeguards and an updated draft of the Code of Practice in 2026.

General practices (GP) are independent businesses contracted by the National Health Service to deliver essential services. As part of their contract, practices must provide online consultation tools. Online consultation tools are designed to accommodate a wide range of patient needs, including improving access to people with disabilities, making it easier for patients to book appointments, request prescriptions, and register remotely.

Since 1 October, GPs now must offer online access during core hours, from 08:00 to 18:30, bringing online access in line with walk-in and access, to improve convenience and reduce phone queues.

After a decade of declining satisfaction, patient experiences with contacting their GP have improved significantly. As of December 2025, 75.2% of patients report that they find it is easy to contact their GP, a 14.3% increase since July 2024, from 60.9%

Our approach is not a one size fits all. The GP Contract is also clear that all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. This means that patients should always have the option visiting their practice in person, or telephoning.

The UK Government is committed to ensuring that people across the United Kingdom live more independent, healthier lives for longer, and will continue to work closely with the Devolved Administrations as needed to achieve this. That is why we will be engaging in the future with the Devolved Administrations on the implications of the forthcoming Health Bill, and the single patient record, to support appropriate cross-border referrals, and appropriate information sharing to inform good decision-making, support healthcare, and minimise risk to patients.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines, medical devices, and blood components for transfusion in the United Kingdom.

Most of the MHRA’s income comes from charging fees for its services. Its fees are set to recover the full cost of delivering the respective services. This is in compliance with the HM Treasury guidance, Managing Public Money.

The MHRA aims to update its fees every two years, so that it can continue to recover its costs. This ensures the agency’s continued financial sustainability, and the ongoing delivery of its services.

The MHRA has recently consulted on its current fee uplift. The consultation has now closed, and they are analysing the responses. The Government response to the consultation should be published in the new year. With regards to the expected impacts:

• the fees uplift will ensure the MHRA’s continued financial sustainability and the ongoing delivery of its services;
• the MHRA’s fees will increase for industry, as by ensuring that the MHRA is fully recovering costs, it will be in a better position to deliver the level of service that the industry wants and expects;
• the MHRA’s fees will increase for everyone, including the National Health Service, however, the impact on the NHS is expected to be small as it represents a small proportion of the MHRA’s total income, and the increase in its costs is also expected to be small; and
• the fees uplift it will ensure the MHRA is sufficiently resourced to deliver its public health duties for patients, and additionally, the charging fees mean that the regulated bear the cost of regulation, rather than the taxpayer and patients themselves.

Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This can include surgical fires or burns. We are informed that NHS England does not define the severity of harm related to surgical fires or burns specifically. Grading the severity of harm related to a patient safety incident that is recorded on LFPSE, should be done using NHS England’s guidance on recording patient safety events and levels of harm, which asks that near miss events be graded as no harm. The guidance is available at the following link:

https://www.england.nhs.uk/long-read/policy-guidance-on-recording-patient-safety-events-and-levels-of-harm/

If a surgical fire or burn is assessed locally and constitutes a patient safety event, it would fall under the scope of the Care Quality Commission’s (CQC) Regulations 16 or 18, and must be reported to the CQC. This means that the most serious surgical fires or burns which result in serious harm or the death of a service user, are subject to mandatory reporting. NHS trusts can comply with this requirement by recording patient safety events using the LFPSE service, and NHS England shares all such data with the CQC, who are responsible for regulating compliance with CQC regulations. CQC Regulations 16 and 18 are available respectively, at the following links:

https://www.cqc.org.uk/guidance-providers/regulations/regulation-16-notification-death-service-user

https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-18-notification-other-incidents

Although the recording of wider patient safety events onto LFPSE is a voluntary process, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.

The LFPSE service and its predecessor, the National Reporting and Learning System, do not have specific categories for surgical fires or burns. Determining how many patient safety events related to surgical fires or burns were recorded by National Health Service providers in each of the last five years would require a search of the free text of recorded patient safety events, using key words, and a subsequent expert clinical review of all potential records to determine relevance to the question. This could only be provided at disproportionate cost.

The Government is investing an additional £600 million this year, and £1 billion next year through the Discharge Fund. This funding will enable the National Health Service and local authorities in England to reduce discharge delays, including by commissioning additional packages of care and support for rehabilitation and reablement.

In September, alongside the £200 million to boost resilience in the NHS, we announced a £40 million fund, targeted at local authorities in the most challenged NHS systems in England. This fund will strengthen urgent and emergency care resilience and performance this winter by preventing avoidable admissions or by reducing discharge delays.

Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This would include incidents caused by surgical fires or burns.

Providers are encouraged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

Recording onto LFPSE is a voluntary process, except where reporting to NHS England fulfils duties for other statutory mandatory requirements, such as reporting notifiable incidents to the Care Quality Commission (CQC). NHS England shares all such data with the CQC. Notifiable incidents include events resulting in “serious harm” or the death of a service user, and therefore the most serious surgical fires or burns are subject to mandatory reporting. However, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.

Published National Safety Standards for Invasive Procedures include a requirement for a risk assessment and management plan to minimise the risk of surgical fires in the perioperative environment. They require that multidisciplinary team training should involve rehearsal and analysis of typical and emergency scenarios, such as a surgical fire, and that prior to surgery, any fire risk and the management plan are discussed and confirmed.

LFPSE is not designed for performance management. However, it supports certain oversight functions within providers, including the ability to review all records submitted by staff, and to mark them as either meeting certain other requirements, such as notification to the CQC, or not. This supports good governance within the provider, encouraging scrutiny of recorded events, and the fulfilment of other statutory or national policy reporting requirements. LFPSE data is being made available to integrated care boards and regional teams to facilitate their roles in safety oversight and provider improvement support.

NHS England does not hold or collect information on the number of surgical fires which occur. Although incidents where serious harm and death are captured within LFPSE, and trusts may choose to record lower levels of harm, there is no category for surgical fires within the existing reporting system with which they could be counted and therefore any count would not be definitive.

Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This would include incidents caused by surgical fires or burns.

Providers are encouraged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

Recording onto LFPSE is a voluntary process, except where reporting to NHS England fulfils duties for other statutory mandatory requirements, such as reporting notifiable incidents to the Care Quality Commission (CQC). NHS England shares all such data with the CQC. Notifiable incidents include events resulting in “serious harm” or the death of a service user, and therefore the most serious surgical fires or burns are subject to mandatory reporting. However, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.

Published National Safety Standards for Invasive Procedures include a requirement for a risk assessment and management plan to minimise the risk of surgical fires in the perioperative environment. They require that multidisciplinary team training should involve rehearsal and analysis of typical and emergency scenarios, such as a surgical fire, and that prior to surgery, any fire risk and the management plan are discussed and confirmed.

LFPSE is not designed for performance management. However, it supports certain oversight functions within providers, including the ability to review all records submitted by staff, and to mark them as either meeting certain other requirements, such as notification to the CQC, or not. This supports good governance within the provider, encouraging scrutiny of recorded events, and the fulfilment of other statutory or national policy reporting requirements. LFPSE data is being made available to integrated care boards and regional teams to facilitate their roles in safety oversight and provider improvement support.

NHS England does not hold or collect information on the number of surgical fires which occur. Although incidents where serious harm and death are captured within LFPSE, and trusts may choose to record lower levels of harm, there is no category for surgical fires within the existing reporting system with which they could be counted and therefore any count would not be definitive.

Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This would include incidents caused by surgical fires or burns.

Providers are encouraged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

Recording onto LFPSE is a voluntary process, except where reporting to NHS England fulfils duties for other statutory mandatory requirements, such as reporting notifiable incidents to the Care Quality Commission (CQC). NHS England shares all such data with the CQC. Notifiable incidents include events resulting in “serious harm” or the death of a service user, and therefore the most serious surgical fires or burns are subject to mandatory reporting. However, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.

Published National Safety Standards for Invasive Procedures include a requirement for a risk assessment and management plan to minimise the risk of surgical fires in the perioperative environment. They require that multidisciplinary team training should involve rehearsal and analysis of typical and emergency scenarios, such as a surgical fire, and that prior to surgery, any fire risk and the management plan are discussed and confirmed.

LFPSE is not designed for performance management. However, it supports certain oversight functions within providers, including the ability to review all records submitted by staff, and to mark them as either meeting certain other requirements, such as notification to the CQC, or not. This supports good governance within the provider, encouraging scrutiny of recorded events, and the fulfilment of other statutory or national policy reporting requirements. LFPSE data is being made available to integrated care boards and regional teams to facilitate their roles in safety oversight and provider improvement support.

NHS England does not hold or collect information on the number of surgical fires which occur. Although incidents where serious harm and death are captured within LFPSE, and trusts may choose to record lower levels of harm, there is no category for surgical fires within the existing reporting system with which they could be counted and therefore any count would not be definitive.

Any unexpected or unintended incident which could have or did lead to harm to one or more patients can be recorded on the Learn from Patient Safety Events (LFPSE) service, to support local and national learning. This would include incidents caused by surgical fires or burns.

Providers are encouraged to foster a positive safety culture among their staff, and ensure an appropriate local focus on incident recognition, recording, and response.

Recording onto LFPSE is a voluntary process, except where reporting to NHS England fulfils duties for other statutory mandatory requirements, such as reporting notifiable incidents to the Care Quality Commission (CQC). NHS England shares all such data with the CQC. Notifiable incidents include events resulting in “serious harm” or the death of a service user, and therefore the most serious surgical fires or burns are subject to mandatory reporting. However, providers are encouraged to record all patient safety incidents, irrespective of the level of harm, to support local and national learning.

Published National Safety Standards for Invasive Procedures include a requirement for a risk assessment and management plan to minimise the risk of surgical fires in the perioperative environment. They require that multidisciplinary team training should involve rehearsal and analysis of typical and emergency scenarios, such as a surgical fire, and that prior to surgery, any fire risk and the management plan are discussed and confirmed.

LFPSE is not designed for performance management. However, it supports certain oversight functions within providers, including the ability to review all records submitted by staff, and to mark them as either meeting certain other requirements, such as notification to the CQC, or not. This supports good governance within the provider, encouraging scrutiny of recorded events, and the fulfilment of other statutory or national policy reporting requirements. LFPSE data is being made available to integrated care boards and regional teams to facilitate their roles in safety oversight and provider improvement support.

NHS England does not hold or collect information on the number of surgical fires which occur. Although incidents where serious harm and death are captured within LFPSE, and trusts may choose to record lower levels of harm, there is no category for surgical fires within the existing reporting system with which they could be counted and therefore any count would not be definitive.

The release of statistics in relation to hospital admissions in Northern Ireland is a matter for the Northern Ireland Department of Health.

The Government continues to support delivery of the NHS Health Check, England’s flagship cardiovascular disease (CVD) prevention programme. The aim of the programme is to prevent heart disease, stroke, diabetes, kidney disease, and some cases of dementia among adults aged 40 to 74 years who receive an invite for a check once every five years. The check assesses seven of the top risk factors for CVD and this includes a blood glucose test to assess for risk of diabetes. The result of the full check will then be used to support individuals to understand their results in relation to their risk of CVD and to provide them with personalised behaviour change advice on lowering their risk.

Integrated care systems (ICS) plan and deliver care for their local populations, including the approach to personalised care and supported self care which is part of the NHS Long Term Plan’s commitment to personalisation.

The Department and NHS England provide support to ICS including through guidance, best practice forums and NHS England’s online collaboration platform and monitors delivery of priorities through mechanisms including the NHS Oversight Framework, including aspects of personalised care

NHS England engaged a wide range of stakeholders including people with lived experience, general practitioner, local authority commissioners, integrated care boards, the Voluntary Community and Social Enterprise sector and national partner organisations to set out the standard model for what makes good supported self-management and what needs to be in place locally.

A summary guide aimed at people and organisations leading local implementation of supported self-management is available at the following link: https://www.england.nhs.uk/wp-content/uploads/2020/03/supported-self-management-summary-guide.pdf

The Delivery Plan for Recovering Access to Primary Care, published on 9 May 2023, describes an ambition to make it easier for patients, where it is clinically safe, to monitor certain long-term conditions at home and easier for practices to review patients that are self-monitoring. Home monitoring can substantially improve health outcomes and reduce the need for regular and urgent appointments. A good example is blood pressure control through home monitoring, reducing heart attacks and strokes. To support this we are providing funding for digital tools so patients can send readings to their practice, where staff can review and add them to their clinical record.

Already more than 30,000 people self-refer each month, and in the 2023/24 operational planning guidance NHS England asks systems to expand this for certain carefully considered community-based services from September 2023. These include selected community musculoskeletal services, audiology for older people including hearing aid provision, weight management services, community podiatry, and wheelchair and community equipment services.

Medical device purchasing decisions are made by individual National Health Service organisations. Decisions are made using frameworks setting out a standardised set of core requirements that include those related to patient safety. NHS England maintains a variety of published guidance using the latest evidence, including on the sterilisation and decontamination of reusable medical equipment and the use of single-use equipment.

In England, all independent sector health and care providers which require Care Quality Commission registration must meet the same standards as any other health care provider. NHS England and the Royal College of Ophthalmologists have worked with National Health Service commissioners and providers and the independent sector to develop a minimum service specification and guidance on cataract provision and guidance to ensure that ophthalmology trainees have access to the appropriate procedures.

There are arrangements in place to assist people on a low income with travel costs to hospital under the NHS Healthcare Travel Costs Scheme.

NHS England commissions specialist allergy services for patients with complex and severe allergy. The service specification sets out that specialist allergy centres should ensure that multidisciplinary care is provided for patients. There are regular review meetings between the regional commissioning teams and providers to ensure compliance with service standards.