The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England, with a range of enforcement powers. The Department holds the CQC to account regularly for its overall performance and delivery of its regulatory functions.

Under the Health and Social Care Act 2008, the CQC has civil and criminal enforcement powers enabling it to protect the public and hold registered providers and managers to account where fundamental standards are not met, or regulated activities are provided without CQC registration. Civil powers focus on reducing risks to people using services, while criminal powers enable the CQC to take action in response to serious failures. In some cases, the CQC may use both types of enforcement action.

Decisions on enforcement action are a matter for the CQC, exercised in line with its statutory remit and published enforcement policy.

Everyone working in the National Health Service has a fundamental right to be safe at work. Individual employers are responsible for the health and safety of their staff, and they put in place measures, including security, training, and emotional support, for staff affected by violence.

In April 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care, announced that the Social Partnership Forum’s recommendations on tackling and reducing violence, part of the 2023 Agenda for Change pay deal, had been accepted in full. This includes measures to improve data and reporting, strengthen risk assessment, and improve training and support for victims. These have been bolstered by the introduction of a new set of staff standards, including one that focuses specifically on tackling violence, as set out in the 10-Year Health Plan.

The Government is prioritising patient safety and a learning culture in the NHS. The changes we are making as part of the 10-Year Health Plan and Dr Penny Dash’s report on the patient safety landscape will improve quality and safety by clarifying where responsibility and accountability sit at all levels of the system. We also plan to develop a new, updated NHS Patient Safety Strategy later in 2026 to continue our focus on improving patient safety.

It is for individual National Health Service organisations, including NHS trusts and integrated care boards, to comply with the Equality Act 2010. Under the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision to ensure that services are as accessible to disabled people, including deaf people, as they are for everybody else. This includes responsibility for ensuring that there is adequate provision of British Sign Language interpreters to support deaf patients.

Health and social care organisations must make reasonable adjustments to ensure that disabled people are not disadvantaged. The Reasonable Adjustment Digital Flag was developed to enable health and care workers to record, share, and view details of reasonable adjustments, across the NHS and social care, wherever the person is seen or treated. Following the launch of the Reasonable Adjustment Digital Flag Information Standard, published September 2023, the flag went live in the National Care Record Service, and is being rolled out across England.

Since 2016, all NHS organisations and publicly funded social care providers are expected to meet the Accessible Information Standard (AIS), which details the recommended approach to supporting the information and communication support needs of patients and carers with a disability, impairment, or sensory loss, including deaf people. NHS England has been undertaking a review of the AIS to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. A revised AIS will be published in due course. In the meantime, the current AIS remains in force, and therefore there should not be a gap in provision for people using services.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses the available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate, to inform regulatory decisions.

Patient safety is our top priority, and no medicine would be approved unless it met our expected standards of safety, quality and effectiveness. Our role is to continually monitor the safety of medicines during their use, including GLP-1 receptor agonists (RAs). We have robust, safety monitoring and surveillance systems in place for all healthcare products.  When a safety issue is confirmed, we always act promptly to inform patients and healthcare professionals and take appropriate steps to mitigate any identified risk. New medicines, such as GLP-1 RAs, are more intensively monitored to ensure that any new safety issues are identified promptly.

It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have been. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.

On the basis of the current evidence, the benefits of GLP-1 RAs outweigh the potential risks when used for the licensed indications. The decision to start, continue, or stop treatments should be made jointly by patients and their doctor, based on full consideration of the benefits and risks. We strongly encourage patients and healthcare professionals to continue reporting suspected side effects to GLP-1 RAs through our Yellow Card scheme.

From the point of licensing up to and including 31 January 2025, the MHRA has received 573 Yellow Card reports for GLP-1 RAs indicated for weight management, where the patient was reported to have been hospitalised.

As the use of the GLP-1 RAs increases, so have the number of Yellow Card reports associated with these medicines. Yellow Card reporting rates can be influenced by many factors, including the seriousness of the adverse drug reactions, their ease of recognition, and the extent of the use of a particular product. Reporting can also be stimulated by publicity and awareness of a product.

The majority of Yellow Card reports for these medicines concern gastrointestinal effects such as nausea, vomiting, and diarrhoea, which are listed as recognised side effects within the product information for these products. These side effects were observed in the clinical trials for these products, with most events being mild to moderate in severity and of short duration. However, they can sometimes lead to more serious complications such as severe dehydration, resulting in hospitalisation.

Saxenda (liraglutide) and Wegovy (semaglutide) are both approved for weight management in adults with obesity, or for those who are overweight with at least one weight-related comorbidity, as well as in adolescents with obesity. Wegovy (semaglutide) is additionally indicated to reduce the risk of serious cardiovascular problems in adults. Mounjaro (tirzepatide) is indicated for both type 2 diabetes and weight management in adults with obesity or overweight and at least one weight-related comorbidity. Ozempic (semaglutide) has been authorised for the treatment of insufficiently controlled type 2 diabetes mellitus in adults. Ozempic is not authorised for weight loss but is sometimes used off-label for that purpose.

The Department does not hold information on the proportion of patients that have been discharged into social care in individual hospitals in each of the last 12 months. NHS England publishes data detailing how many patients are discharged through each discharge pathway, broken down by trust. This includes data on discharge pathway 3, which involves discharge to a care home placement. Further information is available at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/discharge-delays-acute-data/

There are no plans to make an assessment. Through the Government’s manifesto commitment, all trusts that charge for hospital car parking now provide free parking to in-need groups, which include National Health Service staff working overnight, frequent outpatient attenders, disabled people and parents of children staying overnight in hospital.

Information on patient safety incidents is not held in the format requested.

Information on patient safety incidents, including those relating to ambulance services, is published by NHS England as part of the National Reporting and Learning System and is available at the following link: https://www.england.nhs.uk/patient-safety/national-patient-safety-incident-reports/

We are committed to providing high quality National Health Service dental services to people in England regardless of their age, background or disability. Community Dental Services provide NHS dental care to people who cannot be treated in general dental practices. This includes people with learning disabilities, mental health issues or are in situations or locations that is out of reach.

Many of the dentistry commissioning functions undertaken by NHS England will transfer to integrated care boards (ICBs) from April 2023. ICBs will be responsible for meeting the needs of the local population by working with patient groups, including on communication needs. NHS England has made available to commissioners an Assurance Framework to provide assurance that commissioning functions are carried out safely and effectively by ICBs.

With NHS England, we are increasing bed capacity and operational resilience with the equivalent of 7,000 additional beds and a £500 million Adult Social Care Discharge Fund to ensure medically fit patients can safely return home and reducing waiting times in accident and emergency.

We are also investing an additional £3.3 billion in 2023/24 and 2024/25 to return urgent and emergency, elective and primary care services to pre-pandemic levels. The National Health Service will publish recovery plans for urgent and emergency care in the new year.

Patient handovers at accident and emergency (A&E) must take place within agreed timeframes. NHS England is providing targeted support to some hospitals facing delays in the transfer of patients from ambulances to identify interventions. This is in addition to a national Winter Improvement Collaborative programme to assist trusts to identify the causes of delays and implement best practice.

The National Health Service will increase bed capacity by the equivalent of at least 7,000 general and acute beds, alongside a £500 million Adult Social Care Discharge Fund to improve patient flow through hospitals and reduce waiting times in transferring ambulance patients to A&E. In 2020/21, we invested £450 million to upgrade A&E facilities in more than 120 NHS trusts to increase physical capacity and reduce overcrowding.

Local National Health Service trusts are responsible for managing staffing levels and for recruiting the appropriate number of health professionals required to meet local service and patient need. Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Care Quality Commission monitors compliance with Regulation 18 to ensure that providers have sufficient suitably qualified, skilled and experienced staff, who receive effective support, supervision and development and work effectively to provide safe care.

The latest workforce statistics show that there are now more than 29,500 additional staff working in hospitals and commissioning support than a year ago, including over 9,600 more nurses and almost 4,100 more doctors. We have committed to deliver 50,000 more nurses by the end of this Parliament through investment in a diverse training pipeline and recruitment and retention. The Government has funded an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25% increase over three years. To support improving NHS staff retention, 2020 NHS People Plan focuses on staff health and wellbeing, more support for flexible working and a renewed commitment to tackling inequality.

In June 2022, 130,109 patients spent over four hours in an emergency department from the decision to admit to admission to hospital, with 22,034 patients waiting more than 12 hours from decision to admit to admission.

In June 2022, 130,109 patients spent over four hours in an emergency department from the decision to admit to admission to hospital, with 22,034 patients waiting more than 12 hours from decision to admit to admission.

NHS England and NHS Improvement monitor patient safety and work with systems to manage any potential risks. In 2022/23, an additional £50 million has been invested in NHS 111 to support increased call taking capacity and ensure that patients can access urgent care when necessary. NHS England and NHS Improvement are working with integrated care boards to improve patient flow and reduce ambulance handover delays, maximising Same Day Emergency Care services and access to Urgent Treatment Centres as an alternative to accident and emergency where appropriate.

In Slough, funding for 17 intermediate adult social care beds has been extended to June 2022 and an additional 20 bed community ward at Heathlands Heathwood Hospital has been created. An immediate ambulance handover policy is also in place at hospitals in Slough and capacity to accept paramedic handovers increased by 30%.

In the South East, Urgent Treatment Centres and Same Day Emergency Care provision is being developed to ensure alternatives to emergency departments are available at acute sites. This is addition to engaging system partners to alleviate pressures through urgent community response, developing virtual wards, enhanced health care in care homes and bringing together local health systems to reduce length of stay and increase discharges.

There has been a very low incidence of mucormycosis secondary to COVID-19 infections in the United Kingdom. Across 2020 and 2021, there have been 66 incidences of invasive fungal infection, of which only four incidences have been associated with COVID-19.

NHS England and NHS Improvement advise that they have no plans to collect data on general practitioner phone capacity. NHS England and NHS Improvement are working with a number of areas to test advanced telephony requirements and/or specifications, which will improve telephone capacity. NHS England and NHS Improvement intend to share learning from these areas to support practices across the country to improve telephony.

NHS England and NHS Improvement advise that they have no plans to collect data on general practitioner phone capacity. NHS England and NHS Improvement are working with a number of areas to test advanced telephony requirements and/or specifications, which will improve telephone capacity. NHS England and NHS Improvement intend to share learning from these areas to support practices across the country to improve telephony.

The National Immunisation Management System (NIMS) is the national register of COVID-19 vaccinations. At the point that someone receives their COVID-19 vaccine, the vaccinating team will record this information on the NIMS system and onto a patient’s general practitioner record. When patients are vaccinated, they should receive a vaccine record card where the date of their vaccination, the suggested date for their second dose and details of the vaccine type and batch can be recorded.

The National Booking Service is primarily sending physical invite letters to people’s registered addresses. These letters give the option of booking online, or by the free 119 phone line. Others can make an appointment on behalf of individuals who are not able to make it themselves. Follow up phone calls and letters are made to those who have been sent an initial letter but not responded.

We have made no such assessment.

Those being discharged from hospital following an inpatient admission should be tested if they are being discharged to other care settings, such as care homes or hospices. Patients being discharged to home are not routinely tested unless they are thought to have symptoms appropriate for testing.

The data requested on general practitioner (GP) phone reception capacity is not collected or held centrally.

NHS England and NHS Improvement are working through its seven regions, including Slough, to ensure patients can access appointments in general practice.

A £150 million General Practice Covid Capacity Expansion Fund has been made available to support expanding GP capacity up to the end of March 2021. Priorities include increasing GP numbers and capacity, identifying and supporting patients with ‘long’ COVID-19 and continuing to support clinically extremely vulnerable patients.