Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help ensure public (a) safety and (b) clarity in the healthcare roles of (i) physician associates and doctors and (ii) other NHS staff.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The introduction of regulation by the General Medical Council (GMC) will provide a standardised framework of governance and assurance for the clinical practice and professional conduct of Anaesthesia Associates (AAs) and Physician Associates (PAs), and make it easier for employers, patients, and the public to understand the relationship between these roles and that of doctors.
Whilst statutory regulation is an important part of ensuring patient safety, it is also achieved through robust clinical governance processes within healthcare organisations, which are required to have systems of oversight and supervision for their staff.
NHS England is working with the relevant professional colleges and regulators to ensure the use of associate roles is expanded safely and effectively, and that they are appropriately supported, supervised, and integrated into multidisciplinary teams. NHS England has written to trusts to remind them of their responsibilities in this area, with further information available at the following link:
We are clear that AAs and PAs are not, and should never be, referred to as medical practitioners, doctors, or consultants. It is the responsibility of professionals and their employers to ensure professional titles are used appropriately. As set out in the National Institute for Health and Care Excellence’s guidelines, all healthcare professionals directly involved in a patient's care should introduce themselves and explain their role to the patient. The GMC has published interim standards for AAs and PAs in advance of regulation, which make it clear that professionals should always introduce their role to patients and set out their responsibilities in the team.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help support hospital radio stations.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Hospital radio can provide National Health Service patients and visitors with a positive experience at a time when they are feeling vulnerable. NHS trusts work locally with volunteers and organisations to provide this service. Decisions about supporting the service are made most appropriately at a local level.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the effectiveness of NHS England’s Dynamic Support Register policy.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England published updated policy and guidance on Dynamic Support Registers (DSRs) and Care (Education) and Treatment Reviews (C(E)TRs) on 25 January 2023, for implementation from 1 May 2023. The purpose of the updated policy and guidance is to help ensure that people with a learning disability and autistic people get the right support, to stay well in their communities.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of DSRs and C(E)TRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon, and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to monitor the treatment of (a) babies, (b) children and (c) young people by integrated care systems.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
Organisations within integrated care systems (ICSs) that hold the commissioning responsibility for children and young people’s services, provide treatment to the whole population, including babies, children, and young people. There are various mechanisms for monitoring the treatment provided by different organisations, for example general practice services, including immunisations, are monitored via General Practice Indicators.
Statutory guidance sets out that all integrated care boards (ICBs) have an Executive Lead for children and young people, and that all ICB Joint Forward Plans include a section on babies, children and young people.
The Care Quality Commission (CQC) is due to begin assessing ICSs. The Department has asked the CQC, as part of its new scrutiny, to assess whether each ICS is adequately considering health and wellbeing outcomes for babies, children, and young people.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what discussions she has had with NHS England about reducing waiting times for children and young people’s access to (a) community paediatric services, (b) occupational therapy and (c) speech and language therapy.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department holds regular meetings with NHS England on timely access to community health services. Addressing waiting times is a priority for both the National Health Service and the Department. In 2023, NHS England asked local systems to develop plans to reduce community waiting lists.
NHS England is working to improve community health services data to better understand waiting lists and identifying actions to reduce waits, including consideration of new pathways to improve effectiveness and productivity.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure the national allocation of funding for adult social care reflects (a) the number of autistic adults and (b) their potential level of need.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Public spending on adult social care is funded from both local Government revenue and central Government grants and therefore has to be viewed as part of the wider local Government funding settlement. The Department for Levelling Up, Housing and Communities is responsible for the financial framework within which local Government operates and for ensuring the sufficiency of local Government funding.
Central Government grants for adult social care are largely distributed using the Adult Social Care Relative Needs Formulae, which are developed by independent researchers to reflect differences in councils’ need for local authority funded social care, to ensure councils funding reflects the relative level of need in their area. These formulae account for a range of factors including population, income and wealth, levels of impairment and availability of unpaid care support.
Local authorities have discretion over how to use their funding to meet the needs of their local population, including those of autistic adults.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an estimate of the cost of (a) confining autistic adults in mental health hospitals and (b) meeting needs in the community.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Health and Social Care Committee’s report, The treatment of autistic people and people with learning disabilities, included recommendations in relation to assessing the costs of care and support, and redesigning financial incentives in the healthcare system, for people with a learning disability and autistic people. The Government response to the report and position on the recommendations was published 27 July 2022.
In the response, we noted the wide range of capital and revenue funding sources and the range of support that a person may draw on from multiple services. This makes an assessment of costs practically challenging. The response set out that we are clear there must be credible alternatives to inpatient care so that people can live independent, fulfilled lives in their community, without financial incentives or disincentives which prevent this from happening.
To improve our understanding of funding flows, including any financial incentives or disincentives, the Department commissioned an independent specialist consultancy firm, RedQuadrant, in September 2021 to undertake a rapid review of funding flows associated with Building the Right Support. The work concluded in March 2022 and a report was published in July 2022.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will take steps to change funding incentives to help ensure that funding follows need for the right support in the community for autistic adults.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The Health and Social Care Committee’s report, The treatment of autistic people and people with learning disabilities, included recommendations in relation to assessing the costs of care and support, and redesigning financial incentives in the healthcare system, for people with a learning disability and autistic people. The Government response to the report and position on the recommendations was published 27 July 2022.
In the response, we noted the wide range of capital and revenue funding sources and the range of support that a person may draw on from multiple services. This makes an assessment of costs practically challenging. The response set out that we are clear there must be credible alternatives to inpatient care so that people can live independent, fulfilled lives in their community, without financial incentives or disincentives which prevent this from happening.
To improve our understanding of funding flows, including any financial incentives or disincentives, the Department commissioned an independent specialist consultancy firm, RedQuadrant, in September 2021 to undertake a rapid review of funding flows associated with Building the Right Support. The work concluded in March 2022 and a report was published in July 2022.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans she has to update the Building the Right Support action plan.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
There are no current plans to update the Building the Right Support Action Plan as this is a live document and contains a number of commitments which are due to complete after March 2024.
The Building the Right Support Delivery Board continues to monitor both the implementation of the action plan and the relevant data to drive progress on reducing the number of people with a learning disability and autistic people in mental health inpatient settings, identifying new actions and mitigations as appropriate.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 25 October 2023 to Question 202692 on Autism and Learning Disability: Community Care, what the allocation was to each Integrated Care Board for Community/ CYP key workers.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England made a funding allocation for learning disability and autism services, otherwise known as community and children and young people keyworker services, totalling £121.7 million in 2023/24. The following table shows the breakdown of this funding allocation by integrated care board (ICB):
ICB | Organisation Region | Funding allocation 2023/24 (£’000) |
Healthier Lancashire and South Cumbria ICB | North West | 3,964 |
South Yorkshire and Bassetlaw ICB | North East and Yorkshire | 3,044 |
Herefordshire and Worcestershire ICB | Midlands | 1,618 |
Mid and South Essex ICB | East of England | 2,427 |
Bedfordshire, Luton and Milton Keynes ICB | East of England | 1,963 |
Birmingham and Solihull ICB | Midlands | 3,197 |
Cumbria and North East ICB | North East and Yorkshire | 6,929 |
Joined Up Care Derbyshire ICB | Midlands | 2,276 |
Suffolk and North East Essex ICB | East of England | 2,119 |
Devon ICB | South West | 2,584 |
Lincolnshire ICB | Midlands | 1,627 |
Leicester, Leicestershire and Rutland ICB | Midlands | 2,119 |
Our Healthier South East London ICB | London | 3,954 |
Kent and Medway ICB | South East | 3,862 |
Hertfordshire and West Essex ICB | East of England | 2,969 |
East London Health and Care Partnership ICB | London | 4,356 |
North London Partners In Health and Care ICB | London | 3,287 |
Norfolk and Waveney Health and Care Partnership ICB | East of England | 2,280 |
Staffordshire and Stoke On Trent ICB | Midlands | 2,394 |
Frimley Health and Care ICB | South East | 1,435 |
Sussex Health and Care Partnership ICB | South East | 3,629 |
Shropshire and Telford and Wrekin ICB | Midlands | 1,074 |
Greater Manchester Health and Social Care Partnership ICB | North West | 6,623 |
Humber, Coast and Vale ICB | North East and Yorkshire | 3,618 |
Bath and North East Somerset, Swindon and Wiltshire ICB | South West | 1,848 |
Northamptonshire ICB | Midlands | 1,545 |
Gloucestershire ICB | South West | 1,267 |
Hampshire and The Isle Of Wight ICB | South East | 3,744 |
North West London Health and Care Partnership ICB | London | 4,924 |
Somerset ICB | South West | 1,242 |
Nottingham and Nottinghamshire Health and Care ICB | Midlands | 2,501 |
Cornwall and The Isles Of Scilly Health and Social Care Partnership ICB | South West | 1,304 |
Buckinghamshire, Oxfordshire and Berkshire West ICB | South East | 3,425 |
The Black Country and West Birmingham ICB | Midlands | 2,691 |
Cambridgeshire and Peterborough ICB | East of England | 1,769 |
Bristol, North Somerset and South Gloucestershire ICB | South West | 2,067 |
Dorset ICB | South West | 1,705 |
South West London Health and Care Partnership ICB | London | 3,031 |
West Yorkshire and Harrogate (Health and Care Partnership) ICB | North East and Yorkshire | 5,232 |
Coventry and Warwickshire ICB | Midlands | 2,011 |
Surrey Heartlands Health and Care Partnership ICB | South East | 2,034 |
Cheshire and Merseyside ICB | North West | 6,003 |