The Independent Review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder (ADHD), and autism, led by Professor Peter Fonagy, was published on 9 October, providing analysis and recommendations across a wide range of issues, including the current provision of services in relation to autism and mental health.

The Government issued an initial response on the day of publication, available at the link below, but we will set out the full action we are taking in response to the review recommendations in our new Mental Health Strategy, to be published later this year. The Government also remains fully committed to developing and publishing a revised cross-Government autism strategy in line with the Autism Act 2009. We will engage on the development of the revised autism strategy, including on whether the scope of the autism strategy should be extended to cover ADHD.

https://www.gov.uk/government/news/government-pledges-earlier-support-to-tackle-mental-health-crises

The Government recently announced a major expansion of mental health support within the community, with £187 million allocated for 100 community mental health centres, and £156 million for 59 mental health emergency departments.

In addition, people of all ages experiencing a mental health crisis can access support through NHS 111 by selecting the mental health option. This provides access to mental health support and advice, including for children and young people, and can help people access appropriate local services when they need urgent support.

The Government is committed to improving access to high‑quality care and treatment for people with multiple sclerosis (MS) and other progressive neurological conditions.

Through NHS England’s Neurology Transformation Programme, a new model of integrated care has also been developed to support integrated care boards (ICBs) to deliver the right service, at the right time for all neurology patients. This focuses on providing access equitably across the country, with care as close to home as possible, and early intervention to prevent illness and deterioration in patients with long-term neurological conditions, including MS. A toolkit was developed to support ICBs to understand and implement this new model, which includes components on delivering acute neurology services, improving health equity in neurology, and improving community neurology services.

NHS England has published an updated service specification for specialised neurology services, including MS, which sets out clear expectations for proactive, coordinated care to reduce the risk of avoidable complications and emphasises early identification of clinical risks, personalised care planning, and timely access to multidisciplinary support, including specialist nurses, therapists, and community services.

In addition, the GIRFT Programme for Neurology, the RightCare Progressive Neurological Conditions Toolkit, and the model of integrated neurology care developed through the Neurology Transformation Programme support greater consistency, coordination, and sharing of best practice across local systems and geographical areas. NHS England has developed national neurology dashboards, including an MS data dashboard and an interactive adult neurology dashboard, to support systems in monitoring service delivery, benchmarking performance, and understanding the quality of local neurology services.

The National Institute for Health and Care Excellence (NICE) has issued guidance on the use of disease‑modifying therapies for MS, supporting clinicians to offer clinically- and cost‑effective treatments based on the best available evidence. ICBs are expected to have regard to NICE guidance to ensure patients can access high‑quality care and treatment. NHS England also supports the implementation of treatment algorithms to promote consistent prescribing and reduce unwarranted variation in access to high‑efficacy therapies.

The 10-Year Health Plan will also support improved care and outcomes for people with MS by focusing on earlier diagnosis, more timely access to specialist treatment, and more coordinated, community‑based care. It will prioritise reducing unwarranted variation in services and strengthening multidisciplinary support, helping people with MS to manage their condition more effectively and maintain their quality of life.

Finally, a UK-wide neuro forum has been convened, bringing together the governments, health services, and Neurological Alliances of all four UK nations. The forum will share learnings across the UK, and discuss important neurology services transformation and workforce challenges, as well as best practice examples and potential solutions.

The Department has received the request from Torbay Council, and my Rt Hon. Friend, the Secretary of State for Health and Social Care, will respond in due course.

There are a range of legislative and operational safeguards in place to support patient choice and facilitate co-decision between clinicians and patients regarding stoma appliances. In terms of legislation, the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 aim to ensure that pharmaceutical services are delivered in a manner that is not conflicted with inducements that may be provided.

Guidance on Managing conflicts of interest in the NHS, updated in 2024, outlines that in services like stoma, where staff may be sponsored by industry, then such post holders must not promote or favour the sponsor’s specific products, and information about alternative products and suppliers should be provided. In addition, the British Healthcare Trade Association agreed a Code of Practice with its members who are involved in the dispensing of these appliances. The code aims to ensure ethical conduct and to safeguard patient interests in the dispensing process.

How compliance with the safeguards is monitored is a decision for the integrated care systems. Some areas have introduced central prescribing hubs in order to avoid any undue influence from sponsored posts or the dispensing contractors. Under the prescribing hubs a patient can use any dispensing contractor, but the prescription cannot be changed by them.

The Department has not specifically attempted to estimate the full costs to the National Health Service of preventable stoma management or the merits of introducing a nationally mandated annual specialist stoma review requirement within the NHS Standard Contract. However, as part of work linked to reforms of Part IX of the Drug Tariff, the Department is aware that patient experience varies, and through NHS England, is currently reviewing the provision of stoma products and stoma services.

The Department does not hold data on variation between integrated care systems (ICS) in access to specialist stoma review and structured follow-up. However, through this work NHS England has been engaging ICSs to understand what impacts stoma care and to identify improvements.

No assessment has been made by my Rt Hon. Friend, the Secretary of State for Health and Social Care. National Institute for Health and Care Excellence (NICE) guidance on adoption of innovative medicines in local formularies states that once a NICE technology appraisal recommends a medicine, it must be included in a local formulary within 90 days, providing it is clinically appropriate and relevant to the services provided by the organisation, or 30 days for Early Access to Medicines Scheme medicines. This NICE guidance is available at the following link:

https://www.nice.org.uk/guidance/mpg1/chapter/Recommendations#local-formulary-scope

Local formularies exist at various levels of the health service, but most frequently appear at integrated care board (ICB) level. It is the responsibility of local medicines optimisation teams and formulary committees to ensure they are meeting these targets.

At a national level, the Innovation Scorecard and Estimates Report is a publication which reports on the use of medicines and medicine groupings in the National Health Service in England, which have been positively appraised by NICE. It can be used by local NHS organisations to monitor progress in implementing NICE Technology Appraisal recommendations. Further information on the Innovation Scorecard and Estimates Report is available at the following link:

https://app.powerbi.com/view?r=eyJrIjoiOWVkZmY1MDEtOWQzMS00YzU1LWJkZmYtMTc2NGQ2MTZkYjc2IiwidCI6ImNmNmQwNDgyLTg2YjEtNGY4OC04YzBjLTNiNGRlNGNiNDAyYyJ9

In line with commitments made in 2024 Voluntary Scheme for Branded Medicines Pricing, Access, and Growth, NHS England, NICE, and the NHS Business Services Authority are further developing the Innovation Scorecard and Estimates Report to better track variation in the uptake of NICE recommended medicines between ICBs.

The 10-Year Health Plan and Life Sciences Sector Plan set out a commitment to move to a Single National Formulary for medicines within the next two years. The overall aim of the Single National Formulary will be to drive rapid and equitable adoption of clinically- and cost-effective innovations.

Local integrated care systems are responsible for the collaborative commissioning of women’s health and contraceptive services.

The Women’s Health Programme Board provides direction and strategic oversight to NHS England’s Women’s Health Programme.

The board monitors progress and delivery of the Women’s Health Programme, and delivers the ambitions of the Women’s Health Strategy, reflecting the vision to improve health outcomes, reduce disparities, and amplify women’s voices in healthcare.

The board is also responsible for ensuring alignment with wider interdependencies, including the 10-Year Health Plan, and neighbourhood health models, as well as ensuring the delivery, oversight, and performance management of women’s health provision are consistent across the seven regions of England.

Integrated care boards are responsible for the planning, commissioning, and delivery of women’s health services, including oversight of the dedicated Women’s Health Champion role.

The network of women’s health champions brings together senior leaders in women’s health from integrated care systems and local authorities to share best practice to improve women’s health outcomes across the life course and reduce health inequalities. The role is a voluntary commitment, and the Government has no plans to change this.

The number of radiotherapy machines in use which are over the 10-year recommended age is not published by NHS England. The Department also does not hold detailed information about the age of radiotherapy machines, as local systems are responsible for radiotherapy treatment services and since April 2022 the responsibility for investing in new radiotherapy machines has been with local systems.

The Government has invested an additional £70 million of central funding into new LINAC radiotherapy machines to replace older, less efficient machines. These machines are now being rolled out across the country, to help boost radiotherapy productivity and reduce waiting times for cancer patients.

The progress of the NHS Federated Data Platform’s uptake and deployment has exceeded programme expectations, surpassing the projected uptake. The programme planned to deliver to all National Health Service trusts and integrated care boards (ICBs) by 2027, based on a phased implementation over four and a half years. As of 27 November, the programme has signed up 41 of the 42 ICBs and a total of 165 trusts through a formal Memorandum of Understanding, with 122 trusts live or in delivery. Of those trusts signed up to the platform, there are 127 acute trusts, nine community trusts, 26 mental health trusts, and three ambulance trusts. It is anticipated that by the end of its third year the programme will have deployed tenancies to all 246 organisations.

For 2025/26, there is an efficiency and savings target of approximately £11,076 million across all integrated care systems. At month six, the projected delivery for the year remains all but on track against the total efficiency and savings target, with a forecasted shortfall of £5.7 million.

The table below sets out the efficiencies and savings delivered by systems since 2022:

NHS England is responsible for determining funding allocations to integrated care boards (ICBs), including those covering rural areas and West Dorset. This process is independent of the Government and is informed by advice from the Advisory Committee on Resource Allocation (ACRA).

Funding allocations for 2025/26, published on 30 January 2025, include an ACRA-recommended adjustment specifically focused on rurality that reflects the additional cost of providing home-delivered community services in sparsely populated areas, and recognises the longer travel times required to deliver said services. Allocations cover the whole financial year, so there is not winter specific additional funding provided. Further information on funding allocations for 2025/26 is available at the following link:

https://www.england.nhs.uk/publication/allocation-of-resources-2025-26/

All ICBs and trusts have developed their own winter plans, which were stress tested at regional events throughout September to expose any weaknesses and to be strengthen where necessary. We continue to work closely with the most challenged trusts, providing targeted improvement support to help them improve their four-hour and 12-hour performance, and reduce ambulance handover delays.

The Department recognises the importance of understanding productivity variation across integrated care systems (ICSs) to support improvement and to ensure value for money. NHS England routinely collects and analyses data on performance outcomes across ICSs, which is used to provide insight into relative performance at a trust level.

For acute providers, this is included in the NHS Oversight Framework and trusts are segmented based on the latest estimates of a range of metrics, including productivity performance, and ranked in the NHS league tables, which are available at the following link:

https://data.england.nhs.uk/dashboard/nofacute