Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to achieve our ambition of reducing average Category 2 ambulance response times to 30 minutes across 2024/25, including in the North West and Southport. A summary of the progress made and the actions being taken in 2024/25 is set out in Urgent and emergency care recovery plan Year 2: Building on learning from 2023/24, which is available at the following link:

https://www.england.nhs.uk/publication/urgent-and-emergency-care-recovery-plan-year-2-building-on-learning-from-2023-24/

It has not proved possible to reply to the hon Member in the time available before Dissolution.

It has not proved possible to reply to the hon Member in the time available before Dissolution.

Operational delivery of NHS Continuing Healthcare (CHC) is the responsibility of the integrated care boards (ICBs), with oversight from NHS England. The National Framework makes clear that ICBs are expected to reach a decision in most cases within 28 days of being notified of an individual’s potentially eligibility. Further information on the National Framework is available at the following link:

https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

All ICBs must have a CHC local resolution process in place, in order to support individuals who may wish to challenge a decision. NHS England has provided best practice guidance to ICBs, outlining how local resolution should operate. This includes a recommendation that ICBs should complete a request for a local review within three months of receipt. Where it has not been possible to resolve the matter, the individual may apply to NHS England for an independent review of the decision.

Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to achieve our ambition of reducing average Category 2 ambulance response times to 30 minutes across 2024/25, including in Suffolk. A summary of the progress made, and actions taken in 2024/25 is set out in Urgent and emergency care recovery plan year 2: building on learning from 2023/24, which is available at the following link:

https://www.england.nhs.uk/publication/urgent-and-emergency-care-recovery-plan-year-2-building-on-learning-from-2023-24/

Nationally, ambulance trusts received £200 million of additional funding in 2023/24 to increase deployed hours and reduce response times, and this service capacity is being maintained in 2024/25. This is alongside the delivery of new ambulances, and action to reduce handover delays. With more ambulances on the roads, patients will receive the treatment they need more swiftly.

Since we published our plan, there has been significant improvement in ambulance response times, including in Suffolk. In 2023/24, average Category 2 ambulance response time in the East of England was over 23 minutes faster compared to the previous year, a reduction of over 34%.

We have made significant progress in implementing the Delivery plan for recovering urgent and emergency care services since it was published in January 2023. A summary is set out in the document, Urgent and emergency care recovery plan Year 2: Building on learning from 2023/24, which is available at the following link:

https://www.england.nhs.uk/publication/urgent-and-emergency-care-recovery-plan-year-2-building-on-learning-from-2023-24/

Progress includes delivering 5,000 additional core hospital beds, exceeding our virtual ward bed capacity ambition, with over 12,000 now available, and increasing same day emergency care services across the country. These measures are helping to improve patient flow through accident and emergency (A&E) and reduce the ambulance capacity lost to handover delays.

Since the publication of the plan, both A&E and ambulance performance has improved during 2023/24, compared to the previous year. In addition, average ambulance patient handover times have fallen to 32 minutes 42 seconds in April 2024, from 37 minutes 33 seconds in October 2023, when the publication of this data began.

Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to improve accident and emergency waiting times. The plan is available at the following link:

https://www.england.nhs.uk/publication/delivery-plan-for-recovering-urgent-and-emergency-care-services/

Backed by £1 billion of dedicated funding, the National Health Service delivered 5,000 additional core hospital beds in 2023/24, and will maintain this capacity expansion in 2024/25, to support patient flow through hospitals. Accident and emergency waiting times improved year-on-year in 2023/24 for the first time since 2009/10, not including the first year of the pandemic. The NHS Planning Guidance, published in March 2024, commits to further improvements in emergency care performance in 2024/25, with more information available at the following link:

https://www.england.nhs.uk/operational-planning-and-contracting/

The total spend on commissioning specialised services was £22.7 billion in 2022/23 and £25 billion in 2023/24. As formal delegation of specialised services to integrated care boards (ICBs) begins from 1 April 2024, all spend on commissioning these services in previous years has been the responsibility of NHS England, and not the ICBs. For 2024/25, NHS England is delegating £5.3 billion of commissioning resource to ICBs in the three regions, where delegation will begin from April 2024. This figure excludes high-cost drugs and devices spend.

The nine joint committee arrangements arose from a robust process, which included a readiness assessment, the Pre-Delegation Assessment Framework, made between the ICBs and NHS England regional teams, followed by a National Moderation Panel, and final decision taken by the NHS England Board. The NHS England Board papers for February 2023, December 2023, and March 2024 are available, respectively, at the following links:

https://www.england.nhs.uk/wp-content/uploads/2023/02/board-2-feb-23-item-7-delegation-of-spec-comm.pdf

https://www.england.nhs.uk/long-read/specialised-commissioning-2024-25-next-steps-with-delegation-to-integrated-care-boards/

https://www.england.nhs.uk/long-read/specialised-commissioning-update-on-specialised-services-for-delegation/

The process concluded that a transitional year of joint commissioning would offer the most secure and stable transition towards delegation. There is a comprehensive programme structure in place to support the ICBs in the four regions that are working towards delegation in April 2025, to support them in being ready to take on the responsibilities. NHS England is continuing to work alongside ICBs to ensure that delegation agreements are in place, including ensuring appropriate collaborative arrangements are developed to support ICB commissioning of specialised services. These arrangements will be monitored by NHS England through its assurance processes for specialised services.

A webinar series for commissioning staff, including colleagues in ICBs, was delivered in 2023 across different aspects of specialised services, and there are additional webinars planned in 2024. There has been, and will continue to be, local engagement between regional commissioning teams and ICB teams, as the future operating model is co-developed. A suite of support materials has been shared with teams and continues to be updated. As examples, these include: Commissioning Change Management Business Rules; Finance and Accounting Standard Operating Procedure; and the Contracting Standard Operating Procedure.

NHS England develops services specification and clinical policies through its Clinical Reference Groups. There are 250 published service specifications which include clinical pathway, quality, and other relevant standards, which are specific to the clinical service. Regional commissioning teams, overseen by the statutory joint committees, are responsible for implementing the specifications in their commissioning of services, along with assessing compliance against national standards. NHS England has developed Specialised Services Quality Dashboards alongside service specifications, which provide additional data to monitor the quality of services.

As part of the spending review settlement in 2021/22, £17 million was allocated to the National Health Service to address dementia waiting lists, and to increase the number of diagnoses, which had been adversely impacted by the pandemic. NHS England will share learning on the impact of this funding and examples of good practice with dementia clinical networks, by the end of Summer 2024.

However, the dementia diagnosis rate is not calculated for patients aged under 65 years old. This is because the numbers of patients known to have dementia in the sample population age groups comprising the zero to 64 years old age range, is not large enough for reliable estimates to be made.

The Primary Care Dementia Data publication does include a monthly count of the number of patients aged 65 years old and under who do have a dementia diagnosis on their patient record, which is expressed as a raw count, and as a percentage of registered patients aged zero to 64 years old.

As part of the spending review settlement in 2021/22, £17 million was allocated to the National Health Service to address dementia waiting lists, and to increase the number of diagnoses, which had been adversely impacted by the pandemic. NHS England will share learning on the impact of this funding and examples of good practice with dementia clinical networks, by the end of Summer 2024.

However, the dementia diagnosis rate is not calculated for patients aged under 65 years old. This is because the numbers of patients known to have dementia in the sample population age groups comprising the zero to 64 years old age range, is not large enough for reliable estimates to be made.

The Primary Care Dementia Data publication does include a monthly count of the number of patients aged 65 years old and under who do have a dementia diagnosis on their patient record, which is expressed as a raw count, and as a percentage of registered patients aged zero to 64 years old.

Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to achieve our ambition of reducing average Category 2 ambulance response times to 30 minutes across 2024/25, including in the West Midlands and Birmingham. Information on the delivery plan is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2023/01/B2034-delivery-plan-for-recovering-urgent-and-emergency-care-services.pdf

Ambulance trusts received £200 million of additional funding in 2023/24, to increase deployed hours and reduce response times. We will maintain this additional capacity this year, alongside the 5,000 additional permanent hospital beds delivered last year to improve patient flow through hospitals, and reduce ambulance capacity lost to ambulance patient handover delays.

Since we published our plan, there have been significant improvements in ambulance response times, including in the West Midlands. In 2023/24, average Category 2 ambulance response times in the West Midlands were over twelve minutes faster compared to the previous year, a reduction of 25%.

Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to reduce ambulance and emergency department waiting times, including in Yorkshire.

Backed by £1 billion of dedicated funding, we delivered 5,000 additional core hospital beds in 2023/24 and will maintain this capacity expansion in 2024/25. Ambulance trusts received £200 million of additional funding in 2023/24 to increase deployed hours and reduce response times, which will also be maintained this year.

Since we published our plan there have been significant improvements in emergency care performance, including in Yorkshire. In 2023/24, average Category 2 ambulance response times in Yorkshire were over nine minutes faster compared to the previous year, a reduction of 23%, and performance against the four-hour standard for accident and emergency care improved in each integrated care board area in Yorkshire.

The NHS Planning Guidance, published in March, commits to further improvements in emergency care performance in 2024/25, with more information available at the following link:

https://www.england.nhs.uk/operational-planning-and-contracting/

Young onset dementia (YOD), defined as dementia diagnosed under the age of 65.

The dementia diagnosis rate is not calculated for patients aged under 65 years old. This is because the numbers of patients known to have dementia in the sample population age groups comprising those aged between zero and 64 years old are not large enough for reliable estimates to be made.

The dementia diagnosis rate for patients aged 65 years old and over is calculated and published monthly via the Primary Care Dementia Data publication, which is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/primary-care-dementia-data(opens in a new tab)

This publication does include a monthly count of the number of patients aged 65 years old and under who do have a dementia diagnosis on their patient record; this is expressed as a raw count and as a percentage of registered patients aged between zero and 64 years old.

Our Delivery plan for recovering urgent and emergency care services sets out the range of measures being taken to achieve our ambition of reducing average Category 2 ambulance response times to 30 minutes, across 2024/25. Further information on the delivery plan is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2023/01/B2034-delivery-plan-for-recovering-urgent-and-emergency-care-services.pdf

Ambulance trusts received £200 million of additional funding in 2023/24 to increase deployed hours and reduce response times. We will maintain the improved ambulance service capacity from this additional funding in 2024/25, alongside the additional 5,000 permanent hospital beds delivered last year to improve patient flow through accident and emergency, and reduce ambulance capacity lost due to handover delays.

There have been significant improvements in performance across the country, with average Category 2 ambulance response times in 2023/24 over 13 minutes faster compared to the previous year, a reduction of over 27%.

Departmental officials have regular discussions with Northern Ireland and other Devolved Governments on a range of issues, including urgent and emergency care services. There are, however, no specific discussions currently planned on ambulance response times in Northen Ireland.

A quality standard for patient transfers, from critical care to general wards, has been published by the National Institute for Health and Care Excellence, and endorsed by NHS England. The quality standard, which emphasises the importance of continuity in rehabilitation, is available at the following link:

https://www.nice.org.uk/guidance/qs158/chapter/Quality-statement-2-Transfer-from-critical-care-to-a-general-ward

Our two-year urgent and emergency care recovery plan, backed by £1 billion of dedicated funding, was published in January 2023, to drive sustained improvements in urgent and emergency care waiting times.

At York Hospital, an expanded and redesigned emergency department was opened in July 2023. This has improved the provision of services, including same day emergency care (SDEC). SDEC supports patients’ access to timely diagnosis and treatment, without the need for admission to hospital.

The latest published data shows that at York and Scarborough Teaching Hospitals NHS Foundation Trust, the proportion of patients waiting 12-hours from decision-to-admit to admission has reduced by 6.9% in March 2024 compared to the previous year.

What steps her Department is taking to improve accident and emergency waiting times in east Lancashire.