Comparing December 2024 to December 2023, there was a 5% decrease in the average number of patients in hospital with delayed discharge at the end of each day. In December 2024, for patients with a length of stay of at least 14 days, an average of 33% of the delays were attributed to reasons relating to the capacity for onward care and support, due to issues with adult social care services, National Health Services, or housing. This proportion has come down from 37% in June 2024, when this figure was first published.

December 2024 saw record numbers of people attending accident and emergency, a 7.5% increase on December 2023. Despite this, there were 5% fewer delayed discharges than in December 2023.

The Government will tackle delayed discharges by developing local partnerships working between the National Health Service and social care to make sure people do not spend longer than necessary in hospital, and to free up hospital beds. In the integrated care systems that face the most discharge delays, the Department is working directly with partners across health and social care to drive improvements.

Ministers meet regularly with NHS England to discuss discharge and winter performance.

Ministers meet regularly with NHS England to discuss discharge and winter performance.

Integrated care boards (ICBs) have a delegated responsibility for planning and commissioning healthcare services to meet the reasonable needs of the people for whom they are responsible. ICBs should evaluate the needs of the populations for which they are responsible and plan service provision as required.

NHS England will continue to develop national policy and guidance to support ICBs to discharge their primary care commissioning functions effectively, supporting primary care providers and Primary Care Networks to deliver high quality services for patients. The Government is providing the biggest investment into general practice (GP) for years, an additional £889 million on top of the existing budget.

In the event of any GP closure, it is the responsibility of these local commissioners to ensure that patients are able to register with and attend another GP, so that their health needs continue to be met. When a practice does close, patients are informed of the closure and advised to register at another local practice of their choice within their area. Commissioners must put in place appropriate measures to ensure that the affected patients have access to GP services.

Work is already underway to ensure the safeguarding of primary care services. Neighbourhood Health Centres will be trialled to bring together a range of services, ensuring healthcare is provided closer to home. This is part of our broader ambition to move towards a Neighbourhood Health Service, with more care delivered in local communities to spot problems earlier.

The 10-Year Health Plan has been launched to reform the National Health Service and make it fit for the future. The plan will set out a bold agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, from analogue to digital, and from sickness to prevention.

The Government is providing the biggest investment into general practice for years, an additional £889 million on top of the existing budget. We will make sure the future of general practice is sustainable by training thousands more general practitioners, guaranteeing a face-to-face appointment for all those who want one, and delivering a modern booking system.

We are committed to expanding the role of community pharmacies and better utilising the skills of pharmacists and pharmacy technicians. That includes making prescribing part of the services delivered by community pharmacists as we shift care from hospital to the community.

We plan to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to the areas that need them most. To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focus on prevention and the retention of NHS dentists.

NHS England is working to develop a long-term infrastructure strategy including anticipated primary care investment needed to meet demand over the next 10 years and beyond, as well as a detailed look at the quality of the estate.

The Government inherited a £22 billion blackhole in the nation’s finances which has required tough choices around spending priorities. Despite this bleak financial backdrop, we were determined to identify the funding required to support local Individual Placement Support schemes.

The White Paper confirms the Government’s commitment to expand the number of places on these schemes, to help thousands more people with severe mental illness find and stay in employment.

The Government inherited a £22 billion blackhole in the nation’s finances which has required necessary choices around spending priorities. Despite this backdrop, we were determined to identify the funding required to support NHS Talking Therapies.

The White Paper confirms the Government’s commitment to expand access to NHS Talking Therapies for adults in England with common mental health conditions.

We are committed to supporting a professional, well-supported social care workforce. On 6 September 2024, the Department launched the Adult Social Care Learning and Development Support Scheme, which allows eligible employers to claim for funding for certain training courses and qualifications on behalf of eligible care staff. Over 150 courses and qualifications are eligible for funding from this scheme, including the new Level 2 Adult Social Care Certificate qualification. We will continue to work with the adult social care sector and representative organisations to monitor the impact of the funding under the Adult Social Care Learning and Development Support Scheme.

Furthermore, we are working with care workers and employers to develop the next part of the Care Workforce Pathway, the new national career structure for adult social care, which we will publish in due course.

We are committed to supporting a professional, well-supported social care workforce. On 6 September 2024, the Department launched the Adult Social Care Learning and Development Support Scheme, which allows eligible employers to claim for funding for certain training courses and qualifications on behalf of eligible care staff. Over 150 courses and qualifications are eligible for funding from this scheme, including the new Level 2 Adult Social Care Certificate qualification. We will continue to work with the adult social care sector and representative organisations to monitor the impact of the funding under the Adult Social Care Learning and Development Support Scheme.

Furthermore, we are working with care workers and employers to develop the next part of the Care Workforce Pathway, the new national career structure for adult social care, which we will publish in due course.

We are committed to supporting a professional, well-supported social care workforce. On 6 September 2024, the Department launched the Adult Social Care Learning and Development Support Scheme, which allows eligible employers to claim for funding for certain training courses and qualifications on behalf of eligible care staff. Over 150 courses and qualifications are eligible for funding from this scheme, including the new Level 2 Adult Social Care Certificate qualification. We will continue to work with the adult social care sector and representative organisations to monitor the impact of the funding under the Adult Social Care Learning and Development Support Scheme.

Furthermore, we are working with care workers and employers to develop the next part of the Care Workforce Pathway, the new national career structure for adult social care, which we will publish in due course.

Care workers deserve to be recognised and supported for the vital work they do. We want social care to be regarded as a profession, and for the people who work in care to be respected as professionals. That is why, as part of our health mission, we will task regulators with assessing the role social care workers can play in supporting health treatment and monitoring.

We are continuing to develop a national career structure for the adult social care workforce, which will recognise the work care workers undertake, including more advanced and complex care, for instance delegated healthcare interventions. We will also publish updated guiding principles on effective delegation of healthcare interventions to care workers, including the benefits for care workers, the registered nursing workforce, and people who access care.

We are continuing to expand services to treat patients outside of hospitals when they have urgent needs, helping to prevent avoidable hospital admissions and speed up discharges. This includes using virtual wards which have benefited more than 240,000 people across the country so far. The expansion of these innovative services is allowing people to get the specialist care they need safely, and in the comfort of familiar surroundings.

A new virtual wards operational framework by NHS England sets out the further action being taken to improve access to virtual wards. The framework is available at the following link:

https://www.england.nhs.uk/publication/virtual-wards-operational-framework/

We want a society where every person receives high-quality, compassionate care from diagnosis through to end of life. 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, which are respectively available at the following two links:

https://www.england.nhs.uk/publication/palliative-and-end-of-life-care-statutory-guidance-for-integrated-care-boards-icbs/

https://www.england.nhs.uk/publication/service-specifications-for-palliative-and-end-of-life-care-children-and-young-people-cyp/

There is data available from National Health Service bodies to support local quality monitoring, most notably local palliative and end-of-life care profiles, through the data service Fingertips, and other guidance, analyses, and bulletins issued by the National End of Life Care Intelligence Network of the Office for Health Improvement and Disparities, within the Department. Further information on local palliative and end-of-life care profiles through the Fingertips data service is available at the following link:

https://fingertips.phe.org.uk/end-of-life#page/4/gid/1938133060/pat/159/par/K02000001/ati/15/are/E92000001/iid/92489/age/162/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/car-ao-1_car-do-0_tre-do-1

Additionally, the Care Quality Commission publishes ratings for the quality of end-of-life care in hospitals and hospices, and has carried out national reviews. Where people die in acute, community, or mental health hospitals, the National Audit of Care at the End of Life monitors standards related to the quality of the end-of-life care provided.

Furthermore, NHS England has developed a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, 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. Access to the platform is available to anyone with an NHS.net email account.

I recently met with NHS England and discussions have begun on how to reduce inequalities and variation in access to, and the quality of, palliative and end of life care.  We will consider next steps on palliative and end of life care in the coming months.

Under the GP Contract, premises liabilities are the responsibility of the Contractor. Overall contractual payments reflect this arrangement, with the National Health Service also reimbursing direct premises costs including rent, business rates, water, and clinical waste.

There are 8,842 practice premises across England; of these, 51% are leased premises. Integrated care boards (ICBs) are not a formal party to the leases on these properties.

ICBs can hold leases for general practice (GP) or clinical premises, following the transition from clinical commissioning groups which were unable to hold such leases. However, this would require capitalisation of the lease under the International Financial Accounting Standard IFRS16, and limited NHS capital budgets would have to be diverted to offset this commitment, in addition to the payment of rents against the properties.

This would provide, in effect, a double payment of costs against the asset and would commit substantial capital funds to the exercise. Currently, Primary Care Estates capital allocation to integrated care systems would not be sufficient to offset such a capital liability and so an ICB would be required to look to other system partners to provide a capital allocation, thus limiting the ability of the system to invest in primary care estate, address secondary, community care and mental health critical and address the usual infrastructure maintenance requirements.

As a result, in general ICBs entering into sub-leases for large non-owned GP leased premises would not provide the best use of public funds.

The Government plans to tackle the challenges for patients trying to access National Health Service dental care with a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.

We know that patients are finding it harder than ever to see a general practitioner (GP), and we are committed to fixing this crisis in GPs.

Our plan to do so will require both investment and reform. Firstly, we will increase the proportion of funding for GPs in primary care, starting with a commitment to recruit over 1,000 newly qualified GPs through an £82 million boost to the Additional Roles Reimbursement Scheme. This will increase the number of GP appointments delivered, secure the future pipeline of GPs, and will take pressure off those currently working in the system.

Additionally, we will train thousands more GPs across the country, beginning with the training places set out in the NHS Long Term Workforce Plan, which will be key in increasing GP capacity.

We understand that there is pressure on primary care estates and service provision in areas of high population growth. The Government is committed to delivering a National Health Service that is fit for the future, and this means better utilising and expanding primary care infrastructure across the NHS estate. That is why we have set out our intention to fix the front door to the NHS and bring healthcare closer to home, and the local community.

At a local level, the relevant integrated care board is responsible for commissioning, planning, securing, and monitoring general practice (GP) services within their health systems, through delegated responsibility from NHS England. The NHS has a statutory duty to ensure there are sufficient medical services, including GPs, in each local area. It should take account of population growth and demographic changes.

At a national level, we continue to work closely with the Ministry of Housing, Communities and Local Government to ensure all new and existing developments have an adequate level of healthcare infrastructure for the community.