The Modern Service Framework for Palliative Care and End-of-Life Care was never intended to introduce new, ring‑fenced funding. Its primary purpose is to set the strategic direction for improving palliative care and end-of-life care, including reducing variation in access, quality, and outcomes across the system.

In the context of wider fiscal pressures, the focus is on ensuring that existing resources are used as effectively as possible, supported by a shift towards more strategic, population‑based commissioning.

As independent businesses that hold contracts with the National Health Service, practices determine the staffing skill mix to best suit the patients they serve. GP services are commissioned and assured by integrated care boards to meet the needs of changing populations and demographics.

Total full-time equivalent GPs in Castle Point constituency have increased in the past five years, from 31.37 in May 2022 to 41.58 in May 2026.

The Government recognises the valuable contribution of unpaid carers, including young adult carers, and the challenges that caring responsibilities can present for education, training, and employment.

The Department has noted the recent research by University College London City St George’s and the Carers Trust, which contributes to the evidence base and will inform policy development. The Government continues to work across departments to support unpaid carers, including young adult carers, to access the support they need to balance caring responsibilities with education, employment, and their own health and wellbeing.

On 14 July 2026, the Government published the Cross-Government Action Plan for Unpaid Carers, setting out measures to improve recognition of unpaid carers, connect them with the right support, and help them balance caring with work, education, health, and everyday life.

The Government is also committed to improving opportunities for young people to access education, training, and employment. Through the Youth Guarantee and wider skills and employment reforms, the Government is investing £2.5 billion over the next three years to support young people into opportunities to learn and earn.

The Government will continue to review the evidence, including this research, as it develops policies to improve outcomes for unpaid carers and young people.

Information on the Department’s workforce is published monthly on the GOV.UK website, and can be found at the following link:

https://www.gov.uk/government/collections/dhsc-workforce-management-information

The following table shows the number of non-payroll staff recorded in the relevant Monthly Workforce Management Information categories for the Department, in line with published Monthly Workforce Management Information and excluding agencies, at the end of March in each of the last five years:

Since July 2024, the Government has been rebuilding a broken National Health Service dentistry system. We have delivered 1.8 million more dental treatments and reduced the underspend from £392 million in 2023/24 to just £36 million in 2024/25, maximising the treatments provided for taxpayers’ money.

We have brought into force a package of reforms this year to address some of the most pressing issues that dentists and dental teams have been experiencing, including rewarding them more fairly for treating patients with urgent and complex needs.

Strengthening the workforce is key to our ambitions to rebuild NHS dentistry. We are increasing the supply of dentists through a sustained expansion of 50 new dental school places and an increase in exams to allow 2,000 more internationally qualified dentists to practise in the United Kingdom.

In England, under the Care Act 2014, local authorities have a duty to meet the eligible needs of the people in their area including the elderly.

Local authorities in England are also tasked with the duty to shape their care markets to meet the diverse needs of all local people. This includes commissioning a diverse range of care and support services that enable people to access quality care.

The Care Quality Commission (CQC) is assessing how well local authorities in England are delivering adult social care, specifically how local authorities are performing against their duties under Part 1 of the Care Act 2014. All reports and ratings are published on the CQC’s website.

The Government is making over £4.6 billion of additional funding available in England for adult social care in 2028/29 compared to 2025/26, to support the sector in making improvements.

No assessment has been made of either introducing a maximum annual limit on the amount of public funding that may be spent on an individual’s adult social care package, or implementing a cap on annual local authority expenditure on adult social care.

Under the Care Act 2014, access to care and support is based on a person's eligible needs, while any contribution towards the cost of that care is based on what they can afford to pay.

We are considering all options to help reduce waiting times and improve dementia diagnosis and care, including reviewing targets, metrics, and data.

We are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with frailty and dementia, and as part of this exercise, we will develop a list of best evidenced interventions following analysis of the evidence gathering exercise submissions and wider research.

We are committed to reforming the dental contract by the end of this Parliament, with a focus on matching resources to need, improving access, promoting prevention, and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability.

The financial pressures and the cost of new commitments for the National Health Service are analysed as part of the Spending Review process. The 2025 Spending Review sets departmental budgets for day-to-day spending up to 2028/29 and for capital for five years to 2029/30. This level of funding growth is intended to support the NHS in delivering the Government’s priorities, including commitments set out in the Government’s Plan for Change. Further detail is provided at the following link:

https://www.gov.uk/government/publications/spending-review-2025-document/spending-review-2025-html

The Government has committed to hold a Spending Review every two years. The process for the next Spending Review, due to be held in 2027, will be set in due course.

The information is not held in the format requested, and can only be obtained at disproportionate cost.

The forthcoming Modern Service Framework (MSF) for Palliative Care and End-of-Life Care will include a delivery plan to support implementation of the framework. On 4 June, we published an interim update in the form of a Written Ministerial Statement, which is available at the following link:

https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88

The MSF will support the shift to the strategic commissioning of palliative care and end of life care, based on the integrated needs assessment completed by the integrated care board. This supports the effective and equitable use of resources of services commissioned and contracted at a local level to meet identified population needs now and in the future.

We are aware of the Scottish Gluten-free Food Service, under which eligible patients can obtain gluten-free foods through community pharmacy and adults are offered an annual pharmacist health check. While health services are devolved and arrangements in Scotland are a matter for the Scottish Government, we continue to consider evidence and experiences from across the United Kingdom as part of wider policy development.

Community pharmacy in England is already playing an increasing clinical role, but any proposal for a new national pharmacy-led service would require careful assessment of clinical benefit, workforce implications, affordability, and interaction with existing care pathways. The Department will continue to keep relevant evidence and service models under review.

National Health Service optical vouchers are primarily targeted at children and individuals on low incomes to help with the cost of glasses and contact lenses. The NHS complex lens voucher is a separate contribution available to eligible individuals with complex prescriptions who do not qualify for a main NHS optical voucher on income grounds.

The value of NHS optical vouchers and associated supplements is kept under annual review as part of the Department’s usual fee-setting process. No decisions have yet been made on voucher values or supplements for 2026/27.

National Health Service optical vouchers are primarily targeted at children and individuals on low incomes to help with the cost of glasses and contact lenses. The NHS complex lens voucher is a separate contribution available to eligible individuals with complex prescriptions who do not qualify for a main NHS optical voucher on income grounds.

The value of NHS optical vouchers and associated supplements is kept under annual review as part of the Department’s usual fee-setting process. No decisions have yet been made on voucher values or supplements for 2026/27.

No assessment has been made of admiral nurses in England, who are developed and supported by Dementia UK as an independent charitable organisation.

Provision of dementia health services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services, which may include admiral nurses, based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

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.

No assessment has been made of admiral nurses in England, who are developed and supported by Dementia UK as an independent charitable organisation.

Provision of dementia health services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services, which may include admiral nurses, based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

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.

The provision of dementia health care services, including specialist dementia nursing support, is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of the National Institute for Health and Care Excellence guidelines.

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.

No assessment has been made of admiral nurses in England, who are developed and supported by Dementia UK as an independent charitable organisation.

Provision of dementia health services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services, which may include admiral nurses, based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

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.

We have interpreted ‘conversion rates’ as referring to the proportion of individuals found eligible for NHS Continuing Healthcare (CHC) by integrated care boards (ICBs), following the receipt of a positive CHC gateway ‘checklist’ or through another form of referral for assessment of CHC eligibility.

NHS England is responsible for the oversight of ICBs and engages with them regularly through well-established assurance processes to ensure they carry out their functions.

NHS England monitors CHC eligibility rates by undertaking detailed work to compare ICBs with similar demographics. This includes comparing eligibility, conversion, and referral rates and investigating outliers for drivers of variation.

The Office for Health Improvement and Disparities (OHID) produces an annual report which analyses tooth extraction hospital episodes due to tooth decay, and other reasons, in National Health Service hospitals in England for zero to 19 year olds. OHID’s report for 2025 is available at the following link:

https://www.gov.uk/government/statistics/hospital-tooth-extractions-in-0-to-19-year-olds-2025

This report estimates the annual cost of these tooth extractions. The estimated cost of decay-related tooth extractions for zero to 19 year olds for 2024 to 2025 was £51.2 million. OHID continues to analyse, improve, and publish this data to estimate the impact of poor child oral health on NHS hospital costs.

The National Dental Epidemiology Programme is a series of annual oral health surveys that measure the prevalence, as a proportion of the population with the condition, and severity of tooth decay in the survey population. This provides data on oral health inequalities and unmet need. The findings include a measure of clinical signs because of advanced, untreated tooth decay and includes signs of sepsis, but do not estimate associated costs to the NHS.