The Department expects clinicians to take note of the Supporting women and their partners through prenatal screening for Down's syndrome, Edwards' syndrome and Patau's syndrome consensus statement published in an online only format by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and the Society and College of Radiographers.

The consensus statement sets out that all medical professionals involved in the offer of prenatal screening should ensure that women are given results in a non-directive way; the offer of further tests is non-directive; women are signposted to relevant charities and organisations to support personal informed choice; and options following a higher chance result in a non-directive manner. The consensus statement explicitly states that parents whose babies have been identified as having a higher chance of having Down’s Syndrome who have decided to continue with their pregnancy should not have their decisions challenged or be pressured into changing their minds.

In England, to further increase the supply of doctors we have increased the number of medical school places by 1,500 and opened five medical schools. This expansion was completed in September 2020 and the first of these doctors will enter the workforce from 2023. We are also taking action to increase the retention of doctors. The Enhancing Junior Doctors’ Working Lives programme, led by Health Education England, is delivering a range of initiatives to improve the quality of life of doctors in training.

Departmental officials responsible for suicide and self-harm prevention attend regular meetings with officials from devolved administrations to discuss best practice, share learning and look at emerging issues.

The information is not available in the format requested. National Health Service bed capacity is not fixed and is flexible to meet changes in demand. Demand in winter 2021/22 remains uncertain due to factors including hospitalisations of patients with influenza or COVID-19.

The Government is committed to sustainable improvement of the adult social care system and will bring forward proposals in 2021.

On 23 June, the PRINCIPLE clinical trial platform in the United Kingdom announced that ivermectin would be investigated to generate robust data on its effectiveness in treating adults aged 18 years old and over with mild COVID-19 who are at higher risk of developing serious illness. We will closely monitor the data from this trial, as well as emerging clinical trials worldwide to expand our evidence-base on the efficacy of ivermectin in treating COVID-19.

We are committed to bringing forward a proposal for social care this year. The reform of social care and its funding arrangements are complex areas and a range of options for how to deliver on this commitment are being considered.

The Department funds research through the National Institute for Health Research (NIHR). The NIHR has no current active projects into Lyme disease. The NIHR Health Protection Research Unit on Emerging and Zoonotic Infections has undertaken work on the understanding of and treatments for Lyme disease, including looking at incidence of the disease in England and Wales.

At the peak of the COVID-19 pandemic some clinics were suspended but rapidly reinstated and recommendations to continue specialised clinic work in the second wave has been issued. Patients have continued to be both identified and treated.

While such lung function measurements are aerosol generating procedures, advice was circulated by The Association for Respiratory Technology and Physiology to ensure such patients were investigated.

For those patients already receiving treatment the National Institute for Health and Care Excellence guidelines were relaxed to ensure continuation of the drugs and to allow initiation of new therapies.

Wherever possible we have made exemptions to restrictions, to enable people with a learning disability to continue to access the support they need to live fulfilling lives, whilst balancing this with the need to mitigate the risk of transmission of COVID-19.

We have recognised the need for support groups for disabled people to continue and formally organised groups of up to 15 can continue to meet, including day services. Government guidance is clear that people who are unable to put on, wear or remove a face covering because of physical or mental illness or impairment, or disability are exempt from having to wear one. We have engaged with disability charities and other stakeholders using multiple channels to communicate this message to the general public. On 1 December we also published an accessible guidance online regarding the local restriction tiers.

These restrictions are necessary and proportionate to prevent the incidence and spread of COVID-19, to protect the National Health Service and to save lives.

An analysis of the overall health impact of lockdown was published in July. A copy of Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity: Executive Summary is attached.

Estimates of the impact of COVID-19 admissions on NHS capacity was published in October as part of a presentation by the Chief Scientific Adviser. A copy of this presentation is attached.

These set out the risk that non-COVID-19 health services would be impacted at a national level by early December if the NHS were to free-up sufficient capacity to meet the projected hospital admissions from COVID-19 patients. If action had not been taken, we would exceed surge hospital capacity by approximately 4 December, even after postponing some hospital services.

Throughout the pandemic urgent services, such as cancer treatment, urgent operations and stroke care have remained open. Even at the peak of demand, hospitals were still able to look after two non-COVID-19 inpatients for everyone COVID-19 inpatient.

The following table shows the total number of completed admitted pathways during the COVID-19 pandemic period.

Stroke Sentinel National Audit Programme data shows that during the COVID-19 pandemic, improvements were seen in access to stroke units and in the time taken for brain scanning and acute assessments by a stroke specialist. There was a decrease in stroke admissions of 13% during March-May 2020. Seven-day crude mortality data for March-June 2020 shows that there is an overall adjusted risk of mortality of 12% which is consistent with the case mix adjusted 30-day mortality data average of 12% between 2016-2019.

The number of people starting treatment for cancer in August was 78% of the same month last year, having recovered from a low of 63% in May. The majority of people who have not been diagnosed are assessed as being those who did not come forward for checks.

Chemotherapy treatments are largely delivered on a day case or outpatient basis and only a small proportion would normally be delivered in an inpatient setting. Between March and August 2020, there were around 5,300 chemotherapy admissions for inpatient treatment. This is lower than in the same period in 2019, when around 9,000 admissions were recorded. The National Institute for Health and Care Excellence guidance NG161, published in April 2020 to support clinicians in the management of patients requiring systemic treatment through the pandemic, provided advice on alternative chemotherapy treatment approaches to reduce the risk of infection to patients and avoid unnecessary admissions and visits to hospital where possible.

We recognise the impact of the pandemic on people’s mental wellbeing, potentially leading to the onset of new mental health difficulties as well as exacerbating existing problems. We have released tailored guidance on the ‘Every Mind Matters’ website and GOV.UK giving advice and practical steps for people to support their mental health and wellbeing.

National Health Service mental health services have remained open for business throughout this time, including delivering support digitally and by phone. For those with severe needs or in crisis, NHS mental health providers have set up 24 hours, seven days a week urgent mental health helplines. We have also provided over £10 million funding for mental health charities supporting people through the pandemic.

We remain committed to investing at least £2.3 billion of extra funding a year into mental health services by 2023-24 through the NHS Long Term Plan.

The Government funds the Central Booking Service, which is managed by British Pregnancy Advisory Service for access to services under the Abortion Act 1967 in England only.

Health is devolved matter and abortions in Northern Ireland follow the regulations that apply there. Service provision in Northern Ireland, in line with the regulations, is a matter for the Department of Health in Northern Ireland.

Lifestyle changes which may help prevent or delay the onset of dementia include being more physically active, eating healthily and maintaining a healthy weight, not exceeding lower risk levels of alcohol consumption, not smoking, connecting with people and staying mentally active, and controlling diabetes and high blood pressure.

An aspiration of the Government’s Challenge on Dementia 2020 is to improve public awareness and understanding of the factors which can increase the risk of developing dementia and of how people can reduce their risk by living more healthily.

The Department does not set clinical practice. To support clinical practice, the Royal College of Obstetricians and Gynaecologists has considered the issue of fetal pain and awareness in its guideline on Fetal Awareness: Review of Research and Recommendations for Practice.

The Department has brought the article by Dr Stuart W G Derbyshire and John C Bockmann to the attention of the Royal College of Obstetricians and Gynaecologists. It is for the Royal College of Obstetricians and Gynaecologists to consider whether to revise the guidelines having considered the available evidence.