The NHS Health Check, England’s cardiovascular disease prevention programme, aims to prevent heart disease, stroke, kidney disease, and some cases of dementia among adults aged 40 to 74 years old. Through the check, people aged 65 to 74 years old should be made aware of the signs and symptoms of dementia and be signposted to memory services as appropriate.

We will deliver the first ever Frailty and Dementia Modern Service Framework to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected this year. The Frailty and Dementia Modern Service Framework will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.

As part of development, we will consider what interventions should be supported to improve dementia care and diagnosis waiting times, which we know are too long in many areas.

Through the National Institute for Health and Care Research and UK Research and Innovation, the Government is investing in dementia research across all areas, from causes, diagnosis and prevention, to treatment, care, and support, including for carers.

We recognise the importance of a timely diagnosis and remain committed to increasing diagnosis rates and ensuring people can access any treatment licensed or recommended by the National Institute for Health and Care Excellence, and support they need.

We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, which is expected this year.

As part of this exercise, we are considering all options to help reduce variation, including reviewing metrics and targets.

We recognise the importance of a timely diagnosis and remain committed to increasing diagnosis rates and ensuring that people can access any licensed and National Institute for Health and Care Excellence (NICE) recommended treatment and/or support they need.

We will deliver the first ever Modern Service Framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care. The commission is underway and phase one will report this year. The Modern Service Framework for Frailty and Dementia will seek to reduce unwarranted variation and narrow inequality for those living with dementia, as it will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support.

In developing the framework, we are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with dementia. As part of this exercise, we will consider what interventions should be supported to improve diagnosis waiting times, which we know are too long in many areas. We are considering all options to help reduce variation, including reviewing metrics and targets.

Data on the number of glaucoma patients who weren't offered a combined procedure to treat glaucoma at the time of cataract surgery is not held.

The best treatment options will be decided by the treating clinician, in discussion with the patient, considering an individuals’ clinical circumstances and relevant professional clinical guidance and best available evidence.

The Getting It Right First Time programme is also developing best practice guidance for glaucoma services, to support the consistent adoption of high standards of care from detection onwards.

Data on the number of glaucoma patients who weren't offered a combined procedure to treat glaucoma at the time of cataract surgery is not held.

The best treatment options will be decided by the treating clinician, in discussion with the patient, considering an individuals’ clinical circumstances and relevant professional clinical guidance and best available evidence.

The Getting It Right First Time programme is also developing best practice guidance for glaucoma services, to support the consistent adoption of high standards of care from detection onwards.

The Government is working to ensure that patients who have a diagnosis of cancer receive timely, safe, and effective dental care.

NHS England has produced guidelines which aim to ensure that patients across England with a diagnosis of cancer, including oral cancer, have equitable access to oral healthcare. This could include oral health assessments, prevention, rehabilitation, and reconstruction in primary, either National Health Service or independent, community, secondary, or tertiary care settings. This would be provided as part of a multi-disciplinary team care plan. Ongoing oral health management for the duration of the cancer therapy would take place. Further information can be found at the following link:

https://www.england.nhs.uk/publication/oral-healthcare-provision-for-cancer-pathways/

The responsibility for commissioning primary care dentistry to meet the needs of the local population is delegated to the integrated care boards (ICBs) across England. In the South West a number of pilot models are being trialled, for example, if a patient does not have 'a usual dental practice’ and has primary dental care requirements, they will be referred to specific general dental practices, referred to as cancer action support practices, based in ICBs where the pathway is running.

Participation in schemes supporting patients undergoing cancer treatment does not create any automatic entitlement to additional contractual or financial support. Any supplementary funding, including through flexible commissioning, is determined locally and subject to commissioner discretion, identified local need, and available resources.

The Government is working to ensure that patients who have a diagnosis of cancer receive timely, safe, and effective dental care.

NHS England has produced guidelines which aim to ensure that patients across England with a diagnosis of cancer, including oral cancer, have equitable access to oral healthcare. This could include oral health assessments, prevention, rehabilitation, and reconstruction in primary, either National Health Service or independent, community, secondary, or tertiary care settings. This would be provided as part of a multi-disciplinary team care plan. Ongoing oral health management for the duration of the cancer therapy would take place. Further information can be found at the following link:

https://www.england.nhs.uk/publication/oral-healthcare-provision-for-cancer-pathways/

The responsibility for commissioning primary care dentistry to meet the needs of the local population is delegated to the integrated care boards (ICBs) across England. In the South West a number of pilot models are being trialled, for example, if a patient does not have 'a usual dental practice’ and has primary dental care requirements, they will be referred to specific general dental practices, referred to as cancer action support practices, based in ICBs where the pathway is running.

Participation in schemes supporting patients undergoing cancer treatment does not create any automatic entitlement to additional contractual or financial support. Any supplementary funding, including through flexible commissioning, is determined locally and subject to commissioner discretion, identified local need, and available resources.

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.

Patients born with cleft should have care plans tailored to meet their individual needs, with support from multi-disciplinary teams where necessary. Access to dental care is an important part of this and we recognise that some groups of patients may find it difficult to access. We have asked integrated care boards to commission extra urgent dental appointments and are also committed to reforming the dental contract, with a focus on matching resources to need and improving access.

This information is not held centrally.

This information is not held centrally.

The Government recognises the concerns of those who have benefitted from the support of the Queen Elizabeth’s Foundation for Disabled People. We are committed to ensuring that disabled people have equitable, effective, and responsive access to health and care services that meet their needs.

Adult social care services are provided through a largely outsourced market of commercial organisations and charities. Ensuring good management of the market and securing continuity of care in the event of market exit due to business failure is the responsibility of local authorities.

Health and care systems and providers should work together to ensure that efforts to discharge individuals from hospital into social care are joined up and make best use of available resources, in line with the duty to cooperate set out in Section 82 of the NHS Act 2006.

Under the Care Act 2014, local authorities have a temporary duty to ensure that individuals continue to receive the services they need, including National Health Service patients receiving adult social care, if their care provider is no longer able to deliver those services. The Care Act Statutory Guidance provides guidance on managing provider failure and other service interruptions.

Data is not held centrally on dental access and treatment outcomes for people born with a cleft. We recognise that certain groups of patients may be more vulnerable to oral health problems, including patients with clefts.

NHS England commissions services for children, young people, and adults with a cleft lip and/or palate. The patient pathway can start from pre-birth and continues into adulthood. Cleft services provide care through multi-disciplinary teams, and the comprehensive care pathway will include elements such as paediatric dentistry, restorative dentistry, and orthodontics. A copy of the Cleft Lip and/or Palate Services including Non-Cleft Velopharyngeal Dysfunction (VPD) (All Ages) Service Specification is attached.

The NHS Greater Manchester Integrated Care Board is responsible for commissioning services to meet the mental health needs of people across Greater Manchester.

Eye movement desensitisation and reprocessing is recommended as a treatment option for adults with a diagnosis of post-traumatic stress disorder by the National Institute for Health and Care Excellence. People with post-traumatic stress disorder may be able to access it through local NHS Talking Therapies services.

Temporomandibular joint disorder (TMJD) treatment is considered as planned non-emergency care. The NHS.UK website advises that it is not usually serious and generally gets better without treatment. Further information is available at the following link:

https://www.nhs.uk/conditions/temporomandibular-disorder-tmd/

Treatment options for TMJD are:

- conservative treatments such as pain relief, physiotherapy, bite guards, and self-management advice. These are usually provided through primary care and would be considered as non-urgent but necessary care;

- specialist referral, if conservative treatment does not help, specifically referral to oral maxillofacial surgery or a specialist pain clinic may occur. These referrals are part of the routine National Health Service pathways but are prioritised on clinical need; and

- surgical treatments in severe cases, which are scheduled as planned elective procedures. In NHS terms this falls under elective care, but it is not optional in a cosmetic sense, as it is clinically indicated.

NHS England Getting It Right First Time and the Royal College of Surgeons’ Faculty of Dental Surgery have produced guidance to better manage the condition, which is available at the following link:

https://www.rcseng.ac.uk/-/media/FDS/Comprehensive-guideline-Management-of-painful-Temporomandibular-disorder-in-adults-March-2024.pdf

No assessment has been made on the adequacy of the training for general practitioners and dentists on recognising and managing TMJD. The standard of training is the responsibility of the General Medical Council and General Dental Council, which are independent statutory bodies.