Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the Carers UK report State of Caring 2023 — The impact of caring on: health, published in November; and what steps they intend to take in response.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are grateful to Carers UK for having undertaken the research for this report, and we recognise that caring is not always easy or straightforward. There is a wide variety of caring circumstances, experiences and needs among unpaid carers, and the enormous contribution of unpaid carers is reflected throughout Next Steps to Put People at the Heart of Care, published on GOV.UK in April 2023 in an online-only format.
On 24 October 2023, we announced our £42.6 million Accelerating Reform Fund to support innovation and scaling up in adult social care, and to kick-start a change in services provided to support unpaid carers.
We are also investing at least £2.3 billion extra funding a year in expanding and transforming mental health services in England by March 2024. This extra funding will enable an extra two million people, including unpaid carers, to be treated by mental health services within the National Health Service by March 2024.
We know that breaks and respite are important for unpaid carers. This year, £327 million from the Better Care Fund has been earmarked to provide short breaks and respite services and additional advice and support to carers, together with a small number of additional local authority duties.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what discussions they have had with (1) the Chief Pharmaceutical Officer, (2) the Care Quality Commission, (3) the General Pharmaceutical Council, and (4) the Medicines and Healthcare products Regulatory Agency, relating to the performance of homecare medicines services.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has not made an assessment of the performance of the National Homecare Medicines Committee (NHMC). Providers of Homecare Medicine services to National Health Service patients do so under framework agreements and contracts which may be held at national level through NHS England, regional level through NHS procurement hubs, or local level through hospital trusts. This therefore requires a high degree of centralised co-ordination for which the NHMC liaises with homecare providers through their trade association the National Clinical Homecare Association (NCHA) to support and co-ordinate development of the homecare market and discuss any system wide issues. The NHMC includes representatives from the NHS, including NHS England and Pharmaceutical officers, homecare providers, pharmaceutical manufacturer associations and the Care Quality Commission.
NHS England, the NHMC and the NCHA have discussed concerns about the performance of homecare medicines services with officials from the Department.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the performance of the National Homecare Medicines Committee.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has not made an assessment of the performance of the National Homecare Medicines Committee (NHMC). Providers of Homecare Medicine services to National Health Service patients do so under framework agreements and contracts which may be held at national level through NHS England, regional level through NHS procurement hubs, or local level through hospital trusts. This therefore requires a high degree of centralised co-ordination for which the NHMC liaises with homecare providers through their trade association the National Clinical Homecare Association (NCHA) to support and co-ordinate development of the homecare market and discuss any system wide issues. The NHMC includes representatives from the NHS, including NHS England and Pharmaceutical officers, homecare providers, pharmaceutical manufacturer associations and the Care Quality Commission.
NHS England, the NHMC and the NCHA have discussed concerns about the performance of homecare medicines services with officials from the Department.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they intend to take in response to reports that some providers of residential care services are not following government guidelines, and continue to deny residents visits by family and friends even when the home is free from all infections.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government's guidance is clear that every resident should be able to receive at least one visitor in all circumstances. Where visiting is not being supported in line with guidance, we work with the UK Health Security Agency’s health protection teams to resolve any local issues. The Care Quality Commission can also investigate complaints and has regulatory powers to act where providers do not appropriately support people to have access to visits. We recognise that there are instances where residents are unable to receive visitors and we are therefore reviewing further options to avoid restrictions on visiting.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many posts in the Department of Health and Social Care are filled by qualified (1) doctors, and (2) social workers.
Answered by Lord Kamall
There are 49 qualified doctors in Departmental posts. While there is no centralised record of the number of social workers in the Department, there are three qualified social workers in the Chief Social Worker’s office.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what is the most senior post in the Department of Health and Social Care that is occupied by a qualified social worker with experience of working in local government.
Answered by Lord Kamall
The Chief Social Worker for Adults, Lyn Romeo, is a qualified and registered social worker.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the extent to which the organisation of the General Practitioner service continues to be suited to being the foundation of a comprehensive primary care health service.
Answered by Lord O'Shaughnessy
The general practice partnership model has made a huge contribution over the lifetime of the National Health Service. This is why the Secretary of State has commissioned a review of the partnership model. The terms of the review are being developed with the British Medical Association and Royal College of General Practitioners.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the extent to which increased demand on accident and emergency services is influenced by the lack of a comprehensive primary care health service.
Answered by Lord O'Shaughnessy
No formal assessment has been made of the relationship between primary care services and accident and emergency attendances.
Extended access to more convenient appointments later in the evening and at weekends in general practice is now in place for 52% of the population (as at October 2017) and is expected to deliver an additional 9 million consultations following 100% population coverage from October 2018.
Additional comprehensive urgent and emergency care programmes continue to be delivered to help to ease pressures on accident and emergency services and improve the flow of patients through hospitals, such as Urgent Treatment Centres, front door clinical streaming, NHS 111 and the development of NHS 111 Online.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the finding by the Competition and Markets Authority that elderly people in care homes who pay their own fees are subsidising those whose places are paid for by councils by up to £12,000 a year; and whether they intend to take any action to prevent such cross-subsidisation.
Answered by Lord O'Shaughnessy
The Care Act 2014 placed a duty on local authorities in England to shape their local markets to ensure that they are sustainable, diverse and offer high quality care and support for people in their local area. Prices and fee rates paid by commissioners to provider organisations must reflect these new duties.
The Department published the online only Care and Support statutory guidance setting out how councils should meet these new duties when commissioning, including the consideration of the actual costs of care and support when negotiating fee levels. The level of fees charged to a self-funder is a private contractual arrangement.
The Competition and Market Authority’s (CMA) market study into care homes, published on 30 November 2017, raises some complex and important issues for the care home market. Government will publish a formal response to the CMA report within 90 days and will take forward these complex issues as part of the Green Paper on adult social care which will be published in summer 2018.
Asked by: Lord Laming (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have any evidence that those paying the full costs of places in care homes for older people are subsidising those paid for by local authorities.
Answered by Lord O'Shaughnessy
No such estimate has been made. It is for local authorities to plan care provision based on the needs of their local populations. Nationally, the number of care home beds has been stable at around 460,000 beds in England since 2010.
In their 2015 published projections which relate to older people using social care (65+) only, the Personal Social Services Research Unit project increases in publically and privately funded care home residents of 49% and 110% respectively between 2015 and 2035.
Social care continues to be a priority for this Government. This is why local authorities in England will receive an additional £2 billion for social care over the next three years, with £1 billion provided in 2017-18 so that councils can fund more packages of care immediately. One of the three key purposes of the additional funding is to assist councils in stabilising the local provider market.
The Care Act 2014 placed a duty on local authorities in England to promote a diverse, sustainable, high quality market of care and support providers for people in their local area. Local authorities are expected to understand and articulate likely future demand for services in their area, engage with care providers to understand the likely supply of services, provide signals to the market of their intent, and as needed, intervene in the market to stimulate change and innovation in providers to better meet the needs of people and communities.
Prices for care home places are agreed between the provider, the individuals and their families who are self-funding their own care. Prices therefore vary across the country. Central Government has no say in these individual negotiations. The Department continues to support local authorities with their new Care Act duties to ensure their local market remains effective to meet people’s care needs regardless of how services are funded.
The Competition and Markets Authority has an ongoing market study into the residential care market. A financial analysis paper, dated 11 September 2017, contains recent analysis of the charges in place in care homes for self-funders and those supported by a local authority. A copy of Care homes market study is attached.
The full market study is due to be published at the end of November, following which the Government will issue a formal response.