The information requested is not held centrally. To improve waiting times, we have set an expectation that everyone who needs an appointment at a general practice should get one within two weeks, with the most urgent patients being seen on the same day.

The Dementia Care Pathway: Full implementation guidance, commissioned by NHS England, outlines the dementia care pathway and associated benchmarks to support improvements in the delivery and quality of care and support, for people living with dementia and their families and carers. The guide showcases good-practice examples of services that have successfully reduced their waiting times. More information is available at the following link:

https://www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/dementia/nccmh-dementia-care-pathway-full-implementation-guidance.pdf

What steps he is taking to increase awareness of (a) cervical screening and (b) ovarian cancer.

I thank the Minister for that answer, but Target Ovarian Cancer has found that 40% of women in the UK wrongly believe that their smear test will detect ovarian cancer. There is currently no viable screening process for ovarian cancer. However, messaging remains unclear when women are going for their smear test. What steps are being taken to ensure that information provided at such screening is clear?

We are catching more cancers early than ever before, and work to raise awareness of cancer signs and symptoms, screening programmes and investment in early diagnosis are all playing their part. We fund community events to raise awareness of ovarian cancer, and NHS England is working to increase cervical screening take-up by providing more convenient appointments, including at weekends and evenings.

£2.3 billion was awarded at Spending Review 21 to transform diagnostic services over the next three years. Most of this will help increase the number of Community Diagnostic Centres (CDCs) up to 160 by March 2025, expanding and protecting elective planned diagnostic services, including a number delivering endoscopy services. The remainder will increase diagnostic capacity, including endoscopy services, and other productivity improvements including digital transformation.

Direct Spending Review 21 investment in Endoscopy capacity has resulted in a net additional 31 endoscopy rooms in 2022/23, of which five were in CDCs. To date, NHS England have also approved additional investment, expected to deliver a further 25 net endoscopy rooms, of which five are to be in CDCs.

Alongside investment in physical capacity, several schemes are already underway to grow the endoscopy workforce including international recruitment of Clinical Fellows to enable back-fill for gastroenterology trainees to complete training.

Diagnostic Tests undertaken at Community Diagnostic Centres (CDC) is shown in the attached table. The table lists each type of diagnostic test provided in each CDC that is or was operational since June 2021, as well as how many of each test has been carried out at each CDC, as of June 2023. As the first CDCs were rolled out in July 2021, it is not possible to provide data prior to this.

There are 108 CDCs currently operational that have delivered over 4 million additional tests as of June 2023 including large, standard and hub models.

Local NHS services have a duty to ensure that their services are as accessible as possible to their local populations and that any appropriate support is in place. NHS England is working with stakeholders to develop new initiatives to support improvements in coverage and a reduction in health inequalities.

This includes delivering the NHS breast cancer screening uptake improvement plan covering a range of initiatives including a pilot for the proactive follow-up of non-attenders and testing how invitations are sent.

We are also working with NHS England to run an evaluation to test the effectiveness of HPV self-sampling as a primary cervical screening option. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending screening. Such as the availability of appointments, physical disability and past trauma.

Cytosponge enables the detection of Barrett’s Oesophagus, which is a precursor for oesophageal cancer. The Cytosponge test is currently being piloted and evaluated within the NHS through the national cancer programme. There are two programmes being implemented. The first is in secondary care for routine reflux and Barrett’s surveillance. The second is in primary care as proactive case finding.

Since 2021, in the secondary care cohort, over 7100 capsules have been swallowed across 37 trusts. The final evaluation report for the secondary care routine reflux cohort will be published in autumn 2023, and results for the Barrett’s surveillance cohort are expected in 2024. In primary care, the pilot is expected to launch in June 2023 and complete in summer/autumn 2024.

Local NHS services have a duty to ensure that their services are as accessible as possible for their local populations and that any appropriate support is in place. An example is the cervical screening programme, which as well as being accessible through general practices is also accessible through sexual health services.

In 2021, a national marketing campaign to improve uptake of cervical screening had a key focus on supporting LGBT+ people to come forward. We have developed information for all transgender people to inform them about what screening they are eligible for. This information is available at the following link:

https://www.gov.uk/government/publications/nhs-population-screening-information-for-transgender-people/nhs-population-screening-information-for-trans-people

As part of uptake improvement, NHS England has carried out a range of insight work across the three different cancer screening programmes to better understand barriers to coming forward. NHS operational planning guidance 2023/24 supports tackling inequalities with one priority being that health systems are requested to ensure that datasets are timely and complete, with an emphasis on ethnicity coding.

Having more complete and timely data on ethnicity will help to more clearly see how interventions are working across different communities. NHS England is committed to addressing health inequalities using the Core20PLUS5 approach which focuses on vulnerable and under-served groups, including ethnic minority communities.

NHS England is committed to improving the accessibility of the breast, bowel and cervical cancer screening programmes. Providers of NHS screening services are required to make reasonable adjustments to ensure that their services are accessible to disabled people.

The Department and NHS England are working to set out actions to improve accessibility to and uptake of screening including ensuring that Primary Care Networks are provided with primary care data analytics for population segmentation and risk stratification to allow them to understand in depth their populations’ health and care needs for screening programmes. NHS England is supporting a range of research and evaluation to assess the feasibility and acceptability of self-sampling within the NHS Cervical Screening Programme to support an improvement in the accessibility of cervical screening.

The breast screening service offers longer appointments at accessible sites to support women with physical disabilities to have a successful screen. Services make reasonable adjustments, within the constraints of equipment, to ensure that disabled people are offered the opportunity to have breast screening.

The national service specifications aim to ensure local providers support their community to take part in the NHS Bowel Cancer Screening Programme and are monitored by local commissioners. Providers must have systems in place to address inequalities and ensure equity of access for people with protected characteristics if they have a registered general practitioner and identifies and supports people who are considered under-served to access screening.

Regionally and nationally several initiatives have been implemented, from targeting bowel cancer screening awareness campaigns on communities with lower uptake to ensuring information is available in easy read formats, British Sign Language and other languages.

We have announced the roll out of the National Targeted Lung Cancer Screening Programme which will build on the Targeted Lung Health Checks. This programme is targeted at current and ex-smokers between the ages of 55 to 74 years old. After an initial risk assessment, those deemed high risk for lung cancer, will be offered a Low Dose CT scan. If the scan finds a suspicious nodule, they will then be referred to hospital, those with non-suspicious nodules will be asked to come back for an earlier CT scan. Those with a clear CT scan will be reinvited every 24 months until they reach 75 years old. This programme will be available to all eligible people by 2030.

Using the National Health Service ‘Help Us Help You’ campaign local materials have been developed to support outreach with groups in Enfield who experience inequalities around cancer, with a focus on bowel cancer screening.

Online events have been organised, such as webinars and presentations, including to Enfield Borough Partnership Black Health Forum. Enfield’s Learning Disabilities team have also supported outreach with service user groups to inform and participate in the co-production and distribution of easy read resources.

The £10 million funding for breast screening units will provide 28 new breast screening units and 59 upgrades. The timing for delivery of units is individual to each local National Health Service trust.

Neither the Department nor NHS England conducted a public consultation on the diagnostic (a) tests, (b) procedures and (c) equipment available at Community Diagnostic Centres (CDCs). This is because the selection of core services offered by CDCs is a clinical decision and based on the requirements of patients on the waiting list. Core services for standard and large model CDCs are based on recommendations from Sir Mike Richards Review, Diagnostics: Recovery and Renewal, published in November 2020.

For individual CDCs, and proposed spoke site modalities, the inclusion of additional services is based on their own local assessment of clinical need. Public engagement for location and design of CDCs is recommended as part of national guidance.

Community Diagnostic Centres started reporting activity from July 2021. The government does not hold data on activity recorded prior to July 2021 for Community Diagnostic Centres.

Neither the Department nor NHS England conducted a public consultation on the diagnostic (a) tests, (b) procedures and (c) equipment available at Community Diagnostic Centres (CDCs). This is because the selection of core services offered by CDCs is a clinical decision and based on the requirements of patients on the waiting list. Core services for standard and large model CDCs are based on recommendations from Sir Mike Richards Review, Diagnostics: Recovery and Renewal, published in November 2020.

For individual CDCs, and proposed spoke site modalities, the inclusion of additional services is based on their own local assessment of clinical need. Public engagement for location and design of CDCs is recommended as part of national guidance.

Community Diagnostic Centres started reporting activity from July 2021. The government does not hold data on activity recorded prior to July 2021 for Community Diagnostic Centres.

There is no national target specifically relating to the delivery of FibroScan testing for liver fibrosis through Community Diagnostic Centres in England by March 2025.

Diagnostic checks are a key part of many elective care pathways. The NHS’ Delivery Plan for tackling the COVID-19 backlog of elective care has an overall ambition that 95% of patients needing a diagnostic check will receive it within six weeks by March 2025.

The Department has not made a specific assessment of the potential merits of introducing FibroScans in primary care to improve early diagnosis of non-alcohol related fatty liver disease. However, a practice has clinical discretion to decide if a FibroScan is necessary and appropriate for a patient and can either provide directly or through a provider, typically a hospital out-patient appointment.

In addition, NHS England have confirmed they have begun to assess the introduction of FibroScans through Community Diagnostic Centres. £2.3 billion is being spent to increase the number of Centres diagnosing liver disease to at least 100 sites by March 2025. This will boost diagnostic capacity to diagnose liver disease and improve earlier diagnosis and health outcomes.

NHS England’s comprehensive Early Diagnosis strategy is based on six core strands of activity, from raising awareness of cancer symptoms and encouraging people to come forward, to implementing targeted interventions for particular cancer types that we know have previously experienced later stages of diagnosis.

The National Institute for Health and Care Research (NIHR) Clinical Research Network (CRN) supports patients, the public and health and care organisations across England to participate in high-quality research, thereby advancing knowledge and improving care.

The CRN is comprised of 15 Local Clinical Research Networks and 30 Specialties who coordinate and support the delivery of clinical research by region and therapy area.