Community health services including physiotherapy services are locally commissioned to enable systems to best meet the needs of their communities.

We have set a clear target for systems to work to reduce long waits for community health services in NHS England’s Medium Term Planning Framework. By 2028/29, at least 80% of community health services activity should take place within 18 weeks.

Community physiotherapy services in Surrey Heath are provided by Ascenti, a service commissioned from the independent sector by the integrated care boards (ICBs), previously NHS Frimley ICB, now part of NHS Thames Valley ICB. Given the recent inclusion of the Surrey Heath area within the geography of the newly formed NHS Surrey and Sussex ICB, this is one of a number of contracts that is being novated to the new ICB and will be reviewed over time.

Key performance indicators for the community physiotherapy service are measured in terms of number of working days from referral to appointment, and are currently as follows for the Surrey Heath area:

• over the past 12 months, 89% of patients identified as having an “Urgent” condition were seen within ten working days; and

• over the same period, 80% of patients with a non-urgent condition were seen within 28 days.

The Department recognises the importance of ensuring community pharmacy services are safe and accessible to all patients, including those with disabilities and sensory impairments in Surrey and the Surrey Heath constituency.

In addition to the legal requirements under the Equality Act 2010 and the Human Rights Act 1998, pharmacy businesses have a duty to comply with the General Pharmaceutical Council’s (GPhC) standards for registered pharmacy premises. This requires pharmacies to provide an environment that is safe and accessible for all, taking reasonable steps to remove barriers for patients with disabilities. These standards emphasise the need for pharmacies to make adjustments to facilities and services, such as providing accessible entrances, clear signage, and assistance for individuals with mobility or sensory challenges.

To support community pharmacies, and meet their legal duties, the GPhC has issued equality guidance for pharmacies, which outlines best practice for supporting patients with a range of needs. NHS England is also rolling out a Reasonable Adjustment Digital Flag which enables the recording of key information about a disabled patient and the reasonable adjustments to care and treatment that they need, to ensure support can be tailored appropriately and equitably. This is being rolled out nationally across all healthcare settings and will help general practitioners and community pharmacies spot when a patient may need extra support.

Whilst no assessment has been made of the accessibility of community pharmacy services in the Surrey Heath constituency, the GPhC is responsible for holding pharmacy businesses to account and ensures compliance with regulatory standards and guidance as part of routine inspections and fitness to practice procedures.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs) and may include speech and language therapy. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The Government is committed to improving care for everyone with dementia, including those with Primary Progressive Aphasia, which is why we have funded the work of Dementia 100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for busy system leaders and help create communities and services where the best possible care and support is available to those with dementia.

A number of experts, including those with expertise in speech and language therapy and dementia care, provided independent, desktop analysis of the tool, and this invaluable feedback was integrated into the tool.

The D100: Pathway Assessment Tool can be found at the following link:

https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-tool

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs) and may include speech and language therapy. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The Government is committed to improving care for everyone with dementia, including those with Primary Progressive Aphasia, which is why we have funded the work of Dementia 100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for busy system leaders and help create communities and services where the best possible care and support is available to those with dementia.

A number of experts, including those with expertise in speech and language therapy and dementia care, provided independent, desktop analysis of the tool, and this invaluable feedback was integrated into the tool.

The D100: Pathway Assessment Tool can be found at the following link:

https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-tool

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs) and may include speech and language therapy. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The Government is committed to improving care for everyone with dementia, including those with Primary Progressive Aphasia, which is why we have funded the work of Dementia 100: Assessment Tool Pathway programme, which brings together multiple resources into a single, consolidated tool. This will help simplify best practice for busy system leaders and help create communities and services where the best possible care and support is available to those with dementia.

A number of experts, including those with expertise in speech and language therapy and dementia care, provided independent, desktop analysis of the tool, and this invaluable feedback was integrated into the tool.

The D100: Pathway Assessment Tool can be found at the following link:

https://www.rcpsych.ac.uk/improving-care/nccmh/service-design-and-development/dementia-100-pathway-assessment-tool

No assessment has been made of the adequacy of the support available to people of working age living with dementia, including primary progressive aphasia, in the Surrey Heath constituency.

Employers must make reasonable adjustments to make sure workers with disabilities, or physical or mental health conditions, are not substantially disadvantaged when doing their jobs. This applies to all workers, including trainees, apprentices, contract workers, and business partners.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs) and may include speech and language therapy. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The Department is committed to improving integration between health and social care services nationally and locally. Our vision for neighbourhood health will see local government and the National Health Service working more closely together, with a revitalised role for health and wellbeing boards (HWBs) and reform of the Better Care Fund (BCF).

Through the BCF, around £9 billion is being invested in 2025/26 to enable NHS bodies and local authorities to pool budgets and deliver joined-up care. This includes setting shared goals to reduce delayed discharges, avoid unnecessary hospital admissions, and support people to live independently at home.

Whilst no specific assessment has been made of the impact of closer NHS-social care integration on reducing hospital discharge delays in Surrey Heath constituency, local HWBs are required to agree plans under the BCF framework to provide timely and coordinated support for people with complex needs. These plans prioritise effective discharge from hospital and recovery in the community.

Starting in the financial year 2026/27, we will reform the BCF to provide a sharper focus on ensuring consistent joint NHS and local authority funding for those services that are essential for integrated health and social care, such as hospital discharge, intermediate care, rehabilitation and reablement. We will set out further details in due course.

The Department is committed to improving integration between health and social care services nationally and locally. Our vision for neighbourhood health will see local government and the National Health Service working more closely together, with a revitalised role for health and wellbeing boards (HWBs) and reform of the Better Care Fund (BCF).

Through the BCF, around £9 billion is being invested in 2025/26 to enable NHS bodies and local authorities to pool budgets and deliver joined-up care. This includes setting shared goals to reduce delayed discharges, avoid unnecessary hospital admissions, and support people to live independently at home.

Whilst no specific assessment has been made of the impact of closer NHS-social care integration on reducing hospital discharge delays in Surrey Heath constituency, local HWBs are required to agree plans under the BCF framework to provide timely and coordinated support for people with complex needs. These plans prioritise effective discharge from hospital and recovery in the community.

Starting in the financial year 2026/27, we will reform the BCF to provide a sharper focus on ensuring consistent joint NHS and local authority funding for those services that are essential for integrated health and social care, such as hospital discharge, intermediate care, rehabilitation and reablement. We will set out further details in due course.

In the statutory guidance of the Care Act 2014, it states that local authorities must ensure that the services they commission are safe, effective, and of high quality.

Each integrated care board must have an executive lead for learning disability and autism who will support the board in addressing health inequalities, thereby supporting equal access to care across all health services and improving overall health outcomes.

Under the Health and Care Act 2022, Care Quality Commission registered providers are required to ensure their staff receive specific training on learning disability and autism appropriate to their role, to provide safe and informed care.

A Reasonable Adjustment Digital Flag is being rolled out across health and care services to ensure that disabled people’s reasonable adjustments are recorded and shared, to enable tailoring of appropriate support. This is aided by e-learning for health and social care staff.

We are aware of the challenges faced in accessing a National Health Service dentist, particularly in areas such as Surrey, and are taking steps to address this.

The responsibility for commissioning primary care services, including NHS dentistry, to meet the needs of the local population has been delegated to integrated care boards (ICBs) across England. For the Surrey Heath constituency, this is the Surrey Heartlands ICB.

We have asked ICBs to commission extra urgent dental appointments to make sure that patients with urgent dental needs can get the treatment they require. These extra appointments have been made available from April 2025.

We are committed to delivering fundamental reform of the dental contract before the end of this Parliament. As a first step, on 16 December we published the Government’s response to the public consultation on quality and payment reforms to the NHS dental contract. The changes will be introduced from April 2026. These reforms will put patients with the greatest need first, incentivising urgent care and complex treatments. The National Institute for Health and Care Excellence guidance on recall intervals state that a healthy adult with good oral health needs to see a dentist once every two years, and a child once every year. Further information is available at the following link:

https://www.gov.uk/government/consultations/nhs-dentistry-contract-quality-and-payment-reforms/outcome/government-response-to-consultation-on-nhs-dentistry-contract-quality-and-payment-reforms

NHS England have now published the Medium-Term Planning Framework, which is available at the following link:

https://www.england.nhs.uk/publication/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29/

National Health Service organisations are now in the process of developing their operational plans that will detail how they will meet the standards set out in the Medium-Term Planning Framework.

A separate schedule will be issued setting out the ringfence for dental services including 2026/27 to 2028/29 integrated care board pharmacy optometry and dental allocations.

Access to NHS dentistry, including for pensioners and children, remains a priority for the Government.

Whilst no specific assessment of the adequacy of how loneliness among older people has been considered in health and care planning in Surrey Heath, the Department aims to ensure that all demographics, including older people are considered in its policies.

One of the interventions that can work well for people who are experiencing loneliness is social prescribing. Referrals to social prescribing can be made through general practitioners, nurses, and other healthcare professionals, but also wider statutory services such as social care and the voluntary sector, as well as self-referral. Social Prescribing Link Workers connect people to community groups and statutory services for practical and emotional support.

Under the Care Act 2014 local authorities have a duty to promote wellbeing when carrying out care and support duties.

The Department has not had any specific discussions with the providers of sensory and recreational facilities in children’s hospices in Surrey or the Surrey Health constituency. Nor has any formal assessment been made of the role of voluntary and community sector organisations in improving wellbeing and quality of life for children and families in hospice settings in the Surrey Heath constituency.

We recognise the vital role that children’s hospices, including those in Surrey, play in providing holistic, personalised care for children with life-limiting and life-threatening conditions and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing National Health Services. This approach safeguards their independence and autonomy, enabling them to offer services beyond the statutory provision.

As charitable organisations, children’s hospices are able to go above and beyond what the NHS can provide as part of its statutory provision. As such, many children’s hospices provide sensory and recreational facilities, as part of the holistic, wrap-around care that make hospices so valued by the children they support and their families. For example, Shooting Star Children’s Hospice, which provides support to children across Surrey, has a soft-play room, a sensory room, art therapy, music therapy, and other complementary therapies.

The Government made the biggest investment in hospices in a generation, with £100 million to improve hospice facilities, and has also committed £80 million of revenue funding for children’s and young people’s hospices over three years.

As self-employed contractors to the National Health Service, it is up to general practices (GPs) how they distribute pay and benefits to GP nurses and to determine their own staffing arrangements.

GP contractual arrangements do not place any specific obligations on GPs with regard to GP nurse terms and conditions.

The GP workforce is developed with the support of the Frimley ICB Primary Care Training hub. The hub commissions training supported placements for trainees and adoption of primary care network learning environments, in line with the NHS People Promise and interprofessional conferences.

We are investing an additional £1.1 billion in GPs to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26. This is the biggest cash increase in over a decade. The 8.9% boost to the GP Contract in 2025/26 is greater than the 5.8% growth to the NHS budget as a whole.

All digital tools used in primary care must meet minimum functionality standards set by NHS England, ensuring a consistent and high-quality user experience. NHS England provides commercial and procurement support to guarantee that all digital solutions comply with nationally specified clinical safety and technical standards

Online consultation tools offer patients an option to contact their general practice (GP) digitally, allowing them to manage appointments, view and request repeat prescriptions, and register electronically with GP surgeries. They are specifically designed to simplify administrative processes

Experience suggests that extending online access provides significant benefits to both patients and practices. With more patients using online options, phone lines are less busy, which increases availability for those who need additional help or more urgent care

It remains the responsibility of the practice and clinicians to ensure that all patient requests are dealt with appropriately, and that urgent cases are identified and managed safely.

The General Practice contract requires that all patients should always have the option of telephoning or visiting their practice in person, so those without digital access are not disadvantaged.

In February 2025, the General Practice Committee England agreed to make it a contractual obligation for all GP practices to offer access to online services throughout core hours (8:00am–18:30pm, Monday to Friday) bringing online access in line with walk-in and phone access. This will ensure that patients will not have to wait in long phone queues to contact their practice and ensure that those that are not able to use digital booking platforms have an improved user-experience.

Palliative care services, including children’s palliative care services, are included in the list of services an integrated care board (ICB) must commission. To support ICBs, including Frimley ICB and Surrey Heartlands ICB which cover the Surrey Heath constituency, in this duty, NHS England has published statutory guidance and a service specification for children and young people.

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.

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. Shooting Star Children’s Hospice and Alexander Devine Children’s Hospice, which serve children in the Surrey Heath constituency, are receiving £679,148 and £191,824 respectively from this funding.

We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26. Shooting Star Children’s Hospice and Alexander Devine Children’s Hospice have received £1,879,000 and £300,000 respectively from this funding.

We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead.

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.

The Government recognises the vital roles that unpaid carers and families play. The Government is committed to supporting them, including by ensuring that they can effectively raise and resolve complaints about adult social care, including in Surrey Heath.

By law, all health and social care services must have a procedure for dealing efficiently with complaints. Anyone receiving adult social care or their family, carer, or representative has the right to complain about decisions, service delivery, or related issues.

If an individual is not satisfied with the way a provider or local authority has dealt with a complaint, they may escalate it to the Local Government and Social Care Ombudsman (LGSCO) who can investigate individual concerns. The LGSCO is the independent complaints lead for adult social care and investigates complaints from those receiving social care.

The Care Quality Commission (CQC) is the independent regulator for health and social care in England. Whilst the CQC is unable to investigate individual complaints, the CQC encourages the public to “share their experience” through an online feedback mechanism which allows them to raise concerns about the services they receive from providers. Any such cases shared with the CQC will be investigated as part of its ongoing monitoring of providers.

Any form of abuse or neglect is unacceptable. Local authorities have a statutory duty to make enquiries about safeguarding concerns under the Care Act 2014.

Where a local authority has reasonable cause to suspect that an adult in the local authority’s area has care and support needs and appears to be at risk of, or experiencing, abuse or neglect, and is unable to protect themselves as a result of those needs, the local authority must carry out a safeguarding enquiry.

The Government makes it clear, in the statutory guidance of the Care Act 2014, that local authorities must ensure that the services they commission are safe, effective, and of high quality.

The Care Quality Commission has powers to assess how well local authorities in England are delivering their adult social care duties under Part 1 of the Care Act 2014. Surrey County Council was scored a two for the Safeguarding Quality Statement in their assessment, published 20 November 2024. This score indicates evidence of some shortfalls and areas for improvement, such as the need to fully embed processes in place and ensure all staff had adequate and relevant safeguarding training. The assessments will facilitate the sharing of good practice and innovation across local authorities.