The Department does not hold data that would enable us to make an assessment of the potential impact of hospice services on trends in the level of hospital admissions in Lewisham or England.

NHS England is seeking to address workforce shortages, particularly in community care, through the NHS Long Term Workforce Plan (LTWP). The LTWP, published in 2023, sets out the steps the National Health Service and its partners need to take to grow the NHS workforce and deliver an NHS workforce that meets the changing needs of the population over the next 15 years. The LTWP aims to grow the number and proportion of NHS staff working in mental health, primary, and community care, and sets out an ambition to grow these roles 73% by 2036/37.

Most hospices are independent, charitable organisations which develop and adapt their own terms and conditions of employment. The Government has provided £60 million in additional funding to deliver one-off payments to over 27,000 eligible staff employed by non-NHS organisations, including hospices, with contracts to deliver NHS services, and which employ their staff on dynamically linked Agenda for Change contracts.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

There was a huge increase in the number of children and young people in need of eating disorder services due to the pandemic. 8,034 children and young people started treatment in 2019/20, compared to 2022/23, where 11,807 children and young people starting treatment, an increase of 47%. The Department and NHS England are working hard to ensure that everyone has access to the treatment they need.

The Department is providing record investment in mental health services, including for eating disorders services, with £15.9 billion across 2022/23, representing 27.7% more funding than in 2018/19. This includes increasing funding into children and young people's community eating disorder services every year, with funding for eating disorder services increasing by £54 million in 2023/24.

There was a huge increase in the number of children and young people in need of eating disorder services due to the pandemic. 8,034 children and young people started treatment in 2019/20, compared to 2022/23, where 11,807 children and young people starting treatment, an increase of 47%. The Department and NHS England are working hard to ensure that everyone has access to the treatment they need.

The Department is providing record investment in mental health services, including for eating disorders services, with £15.9 billion across 2022/23, representing 27.7% more funding than in 2018/19. This includes increasing funding into children and young people's community eating disorder services every year, with funding for eating disorder services increasing by £54 million in 2023/24.

While the National Health Service has always been required to commission appropriate palliative and end of life care services to meet the reasonable needs of their population, in 2022, palliative care services were added to the list of services an integrated care board (ICB) must commission, promoting a more consistent national approach and supporting commissioners in prioritising palliative and end of life care in all settings. To support ICBs in this duty, NHS England has published statutory guidance and service specifications for both adults and children.

From April 2024, NHS England will include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. Additionally, NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together relevant, all age local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of both adults and children in their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities.

NHS England has also funded seven Palliative and End of Life Care Strategic Clinical Networks, each with a dedicated Children and Young People Lead. These networks support commissioners in the delivery of outstanding clinical and personalised care for people in the last year of life and reduce local variation.

The Comprehensive School Safety Framework is well aligned with UK priorities, and we support its implementation through our funding to Education Cannot Wait. The UK has endorsed the Safe Schools Declaration which commits to reducing the impact of conflict on education and is closely linked to the Comprehensive School Safety Framework. FCDO officials will discuss endorsing the framework with The Global Alliance for Disaster Risk Reduction and Resilience in the Education Sector.

The FCDO supports the education workforce in crises-affected countries through our support to multilateral partners; our bilateral programmes; and our wider policy work on strengthening education systems and foundational learning. The UK is the second largest donor to Education Cannot Wait, which has funded the recruitment and/or financial support for nearly 170,000 teachers between 2016 and 2022. The UK is also the second largest donor to the Global Partnership for Education (GPE), which spends over 60 percent of its funds in fragile and conflict affected states and directly supports teacher recruitment, training and safer school environments.

In 2023, we pledged £80 million to Education Cannot Wait (ECW), a global fund for education in emergencies, central to supporting education resilience in the face of increasing natural and man-made disasters. The FCDO's position paper, 'Addressing the Climate, Environment, and Biodiversity Crises in and through Girls' Education' (2022), provides a framework of priority actions to build resilient and climate smart school systems. Increasingly, our bilateral education programmes are building climate resilience, and we are working, as leading donors, through global education funds - Global Partnership for Education and ECW - to protect education in the face of disasters.

NHS England is seeking to address shortages in the workforce, and particularly in community care, through the NHS Long Term Workforce Plan (LTWP). The LTWP, published in 2023, sets out the steps the National Health Service and its partners need to take to grow the workforce, and deliver a workforce that meets the changing needs of the population over the next 15 years. It will put the workforce on a sustainable footing for the long term. The LTWP aims to grow the number and proportion of NHS staff working in mental health, and primary and community care, and sets out an ambition to grow these roles by 73%, by 2036/37.

The Department has delivered on the Government’s commitment of 50,000 additional nurses, with over 363,000 nurses working across the NHS, which is over 62,000, or 20.7% more than September 2019. More widely, data for September 2023 from the Nursing and Midwifery Council shows there are over 58,300 registered children’s nurses across the United Kingdom. This is over 6,500, or 12.7%, more than in 2019.

Any Hours is a programme that allows for more flexible working hours and patterns. Wherever there are shifts that are unfilled, Any Hours allows midwives to choose when, where, and the number of hours they want to work. Lewisham and Greenwich NHS Trust data shows that since the Any Hours Scheme was enacted, it has released, on average, 300 hours a month, equalling two whole time equivalent midwives’ released every month. The Any Hours programme is expected to be featured as a case study by NHS England.

Any Specialty is a programme to encourage all Band 6 midwives to spend 15 hours a month, or two days, in a different speciality of their choice. This allows colleagues to improve the competencies and skills needed to help their career progression, or even to directly apply to a specialist midwife role at the trust. To date, specialties have recruited nine midwives following Any Specialty contact at Lewisham and Greenwich NHS Trust.

NHS England has confirmed it will renew the Children and Young People hospice funding for 2024/25, again allocating £25 million of funding for children’s hospices, using the same prevalence-based allocation approach as previously used. Funding will be distributed via integrated care boards (ICBs), in line with National Health Service devolution.

NHS England wrote to all ICBs and children’s hospices on 9 April 2024 to confirm the new arrangements, providing the sector with the clarity on 2024/25 allocations they have been seeking, for this very important funding stream.

Data on the average time taken to diagnose pancreatic cancer is not published by NHS England who are responsible for publishing cancer waiting times data. NHS England is working to meet the Faster Diagnosis Standard (FDS), which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out. Latest published data from February 2024 shows FDS performance was 78.1% nationally. Of those patients referred to Lewisham and Greenwich NHS Trust in February 2024, 81.2% received a diagnosis or ruling out of cancer within four weeks which was above the 75% standard. For the same period 76.2% of patients referred to providers part of NHS South East London Integrated Care Board received a diagnosis or ruling out of cancer within 28 days.

Data on FDS does not individualise pancreatic cancer specifically, however it does include suspected upper gastrointestinal (GI) cancer, which encompasses pancreatic cancer, at provider level. Of those patients referred to Lewisham and Greenwich NHS Trust for suspected GI cancer in February 2024, 82.3% received a diagnosis or ruling out of cancer within four weeks.

The Department is taking steps to reduce cancer treatment waiting times across England, including the time between an urgent general practitioner referral and the commencement of treatment. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.

Flexible working arrangements, or We work flexibly, is one of the elements contained in the NHS People Promise, with a commitment to deliver for staff, including midwives, by 2024/25. NHS England has created and shared flexible working arrangement resources, and delivered bespoke webinars and workshops on the issue. They have also brought together midwifery leaders from across the system to share good practice, foster collaboration, and support the implementation of flexible working across maternity services.

In September 2021, contractual changes took effect for employees covered by the NHS Terms and Conditions of Service Handbook, which includes the right to request flexible working from day one, without the need to provide a justification.

Flexible working is one of the key pillars of improving staff experience and retention, as set out in the Long Term Workforce Plan. It will contribute to the aim of retaining up to 130,000 more staff over the course of the plan. However, no assessment of the benefits of introducing more flexible working arrangements specifically for maternity staff has been made.

The NHS Long Term Workforce Plan sets out how to improve culture and leadership, to ensure that up to 130,000 fewer staff leave the National Health Service over the next 15 years. This includes: implementing actions from the NHS People Plan that have been shown to be successful; implementing plans to improve flexible opportunities for prospective retirees, and delivering the actions needed to modernise the NHS pension scheme; and committing to ongoing national funding for continuing professional development for nurses, midwives, and allied health professionals, so NHS staff are supported to meet their full potential. These measures apply across staff groups, including maternity staff.

It is the responsibility of integrated care boards to make appropriate provision available, to meet the health and care needs of their local population, including access to attention deficit hyperactivity disorder (ADHD) assessments, in line with relevant National Institute for Health and Care Excellence (NICE) guidelines. The NICE’s guidelines for ADHD diagnosis and management aim to improve the diagnosis of ADHD, as well as the quality of care and support people receive. The NICE’s guidelines do not recommend a maximum waiting time standard for ADHD diagnosis, either from referral for an assessment to receiving an assessment, a diagnosis, or a first contact appointment.

There is, at present, no single, established dataset that can be used to monitor waiting times for the assessment or treatment for ADHD nationally. The Department is exploring options to improve data collection and reporting on ADHD assessment waiting times, to help improve access to ADHD assessments in a timely way and in line with the NICE’s guideline. In support of this, the National Institute for Health and Care Research’s Policy Research Programme has commissioned a research project to provide insights into local ADHD diagnosis waiting time data collection.

NHS England is establishing a new ADHD taskforce alongside the Government, to improve care for people living with the condition. The new taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to better understand the challenges affecting people with ADHD, and help provide a joined up approach in response to concerns around rising demand for assessments and support.

Alongside the work of the taskforce, NHS England has announced that it will continue to work with stakeholders to develop a national ADHD data improvement plan, carry out more detailed work to understand the provider and commissioning landscape, and capture examples from local health systems who are trialling innovative ways of delivering ADHD services, to ensure best practice is captured and shared across the system.

No specific assessment has been made. Menopause is a priority area within the Women’s Health Strategy, and the Department and National Health Service are implementing an ambitious programme of work to improve menopause care so all women, including those with autism and attention deficit hyperactivity disorder (ADHD), can access the support they need.

Integrated care boards (ICBs) are responsible for providing services that meet the needs of their local population. Every ICB is expected to have an Executive Lead for learning disability and autism, whose remit includes supporting the board in addressing the health inequalities that autistic people and people with a learning disability experience, and supporting equal access to care across all health services.

From 1 July 2022, the Health and Care Act 2022 requires Care Quality Commission registered providers to ensure their staff receive specific training on learning disability and autism, appropriate to their role. Since November 2022, over 1.7 million people have completed the first part of Oliver McGowan Mandatory Training on Learning Disability and Autism. In addition, NHS England is improving the use and recording of reasonable adjustments to ensure care is tailored appropriately for disabled people, including people with autism and ADHD.

The Department works with NHS England on a regular basis to review the numbers of staff working in National Health Service maternity services, and to identify any issues which could potentially impact services.

Growing, retaining, and supporting the maternity workforce to ensure that there are staff with the capacity and the right skills to deliver safe, personalised, and equitable care for women and babies is a key theme of NHS England’s Three Year Delivery Plan for Maternity and Neonatal Services. NHS England is also delivering a nursing and midwifery retention programme, supporting organisations in assessing themselves against a bundle of interventions aligned to the NHS People Promise, and to develop high-quality local retention improvement plans.

The Health and Care Act 2022 requires Care Quality Commission registered providers, which includes maternity services, to ensure their staff receive specific training on learning disability and autism, appropriate to their role. We are rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to support this. This training will help to ensure that staff have the right skills and knowledge to provide safe and compassionate care, including how to provide reasonable adjustments for autistic people.

NHS England is also working to improve the use and recording of reasonable adjustments to make it easier for autistic people to use health services, by ensuring care is tailored appropriately. This includes the development of a Reasonable Adjustment Digital Flag, which will enable the recording of key information about a patient, including if a person is autistic, and their reasonable adjustment needs, to ensure support can be tailored appropriately.

The information requested is not held centrally, but may be held by individual providers or integrated care boards (ICBs). However, some relevant information is available for autism assessments. In the NHS South East London ICB, in December 2023, there were a total of 1425 patients with an open suspected autism referral. The median waiting time of patients in this ICB with an open suspected autism referral, where their first care contact was in the quarter, was 545 days. Across England, in December 2023, 80,718 female patients had an open suspected autism referral.